Deficiency in Insurance Services: Govt amends Insurance Ombudsman Rules for better resolution of policyholders’ complaints

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March 3, 2021 3:32 PM

The amended rules have enlarged the scope of complaints to Ombudsmen from only disputes earlier to deficiencies in services on the part of insurers, agents, brokers and other intermediaries.

Under the amended rules, the timeliness and cost-effectiveness of the mechanism has been substantially strengthened.

Good news for policyholders. With a view to improve the working of the Insurance Ombudsman mechanism to facilitate resolution of complaints regarding deficiencies in insurance services in a timely, cost-effective and impartial manner, the government has notified comprehensive amendments to the Insurance Ombudsman Rules, 2017.

The amended rules have enlarged the scope of complaints to Ombudsmen from only disputes earlier to deficiencies in services on the part of insurers, agents, brokers and other intermediaries. Further, insurance brokers have been brought within the ambit of the Ombudsman mechanism, by empowering the Ombudsmen to pass awards against insurance brokers as well.

Under the amended rules, the timeliness and cost-effectiveness of the mechanism has been substantially strengthened. Policyholders will now be enabled for making complaints electronically to the Ombudsman and a complaints management system will be created to enable policyholders to track the status of their complaints online.

Further, the Ombudsman may use video-conferencing for hearings. To enable access to relief through the Ombudsman mechanism even when there is vacancy in the office of a particular Ombudsman, provision has been made for giving additional charge to another Ombudsman, pending the filling of the vacancy.

A number of amendments have been made for securing the independence and integrity of the Ombudsman selection process, while also building in safeguards to secure the independence and impartiality of the appointed persons while serving as Ombudsmen. Further, the selection committee will now include an individual with a track record of promoting consumer rights or advancing the cause of consumer protection in the insurance sector.

The Ombudsman mechanism was administered by the Executive Council of Insurers, which has been renamed as the Council for Insurance Ombudsmen.

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