Attention is drawn to Authority’s Circular No. IRDAI/CAD/CIR/MISC/063/03/2016 dated 01-04-2016 vide which all Insurers were directed to submit data pertaining to compliance of awards passed against them by Insurance Ombudsman.
Upon perusalof the data received from all Insurers for the period April, 2018 to December,2018, the following observations are made:
a) While Insurance OmbudsmanRules, 2017 mandate Insurers to comply with the awards passed by Insurance Ombudsman within a period of 30 days of receipt of award, many Insurers are neither complying with the awards nor filing appeals within 60 days of receipt of awards in accordance with provisions of circular referred above.
b) While submitting the statement, reasons for pendency for each award have to be mentioned separately. However, many Insurers are not mentioning the same.
c) Few Insurers are not even submitting statements prescribed under above mentioned circular to designated person.
Upon calling for reasons for non-compliance from the Insurers, few Insurers are submitting that they have complied with the award post timelines stipulated under the above mentioned rules. Non-compliance of these awards within the timelines prescribed would severely undermine the grievance redressal framework laid downand cause undue hardships to the policyholder.
In view of the above, all Insurers are hereby cautioned that non submission of statements prescribed under above mentioned circular and non-compliance of awards by Insurers within the timelines prescribed under Insurance Ombudsman rules, 2017 will be viewed very seriously.
TS Naik General manager,
Consumer Affairs Department.