Issue It would help consumers greatly the IRDA provides details about the insurance companies that follow the regulations.

Srikaran paid a premium of Rs.17,831 and took a medi-claim policy through an intermediary. He did not receive any papers pertaining to the policy and a few months prior to the time the next premium was due, Srikaran wrote to the insurance company’s local office asking for the original documents. As there was no response, he visited the office in person with no fruitful results and later, after two more visits and much insistence, he was told that the local office had nothing to do with the matter and was advised to contact the head office.

Srikaran promptly contacted the head office of the public sector company hoping that the issue would be resolved immediately but was greatly disappointed when the head office failed to even acknowledge the complaint received. The numerous representations made by him fell on deaf ears and a flustered Srikaran approached us for assistance.

We took up the matter with the head office, asking them to respond to the concerns of Srikaran. There was no response for almost three months and with two reminders sent in the meanwhile, the head office replied stating that since the policy was issued as a tailor-made group medi-claim policy covering the existing customers of the intermediary, the question of issuing of policy on individual basis did not arise.

Now, to give this reply, the insurance company needed more than a year! If this were the going to be the promptness and style with which insurance companies responded to consumers’ queries, then consumers’ faith in the system is certainly likely to take a nose-dive.

In fact, the Insurance Regulatory and Development Authority (IRDA) has stipulated that each insurance company should codify and make public the way it will deal with consumer complaints and resolve them. In order to protect the interests of policy holders, the IRDA came out with the IRDA Protection of Policyholders’ Interests Regulations in 2002. These regulations not only emphasise on the consumer’s right to complete information relating to the policy but also specify time limits for claim settlement. It stresses on the fact that there should a specific turnaround time for all services.

To enable effective monitoring of the Policy holder protection Regulations and the Grievance Guidelines, as well as to create a central repository of industry-wide insurance grievances data, the IRDA has set up the Integrated Grievance Management System (IGMS). The IGMS keeps track of the insurers’ performance and also the complaints registered, and takes suitable action whenever necessary. Data on the total number of complaints received against insurance companies, the number of complaints resolved and those pending are provided in the website of the IRDA.

Moreover, it is interesting to see that the regulator has issued warning letters to various insurance companies, most of which are for violation of the IRDA Protection of Policyholders’ Interests Regulations. Issues like failure to inform the policyholder about the claim procedures, delay in claim settlement, delay in redressal of grievances, not providing the policy terms and conditions while handing over the policy papers have all been taken serious note of and the respective erring companies warned and told that they should abide by the regulations strictly. It would be more revealing and help consumers make an informed choice if the IRDA also provided details about the insurance companies that followed the regulations and voluntarily offered penalties for the delays.

Though the above proves that IRDA is a more proactive regulator, it is important for the insurance companies to be more consumer-friendly and transparent in their approach as well so that consumers stand to gain.

S. SAROJA

(The writer works with CAG, which offers free advice on consumer complaints to its members. For membership details / queries contact 2491 4358 / 2446 0387 or helpdesk@cag.org.in)

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