GBIC Governing Body of Insurance Council Procedure Complaint Insurance Ombudsman

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GBIC:
The Governing Body of Insurance Council (GBIC) has been established under Redressal of Public Grievances Rules 1998, to set-up and facilitate the Institution of Insurance Ombudsman in India.
The Governing Body of Insurance Council consists of one representative each from all insurance companies; the representative is required to be either the Chairman or Managing Director or a Director of the company represented.

Objective of RPG Rules (1998) – The objective of these Rules are to resolve all complaints relating to settlement of claim on the part of insurance companies in cost effective, efficient and impartial manner.

Procedure:
If you have an Insurance Policy on personal lines and have a grievance against an insurance Company complaint can be filed by Policyholder or claimant/legal heirs
  • Please write to the Grievance Redressal Officer of the Insurance Company . Click here for contact details of Grievance Redressal Officers, GRO of all Insurance Companies.
  • The insurance company should deal with your complaint within 30 days.
  • If you are unhappy with the solution or if there is no response to your complaint from the GRO for 30 days, then you can approach the Office of Insurance Ombudsman as per jurisdiction for value of the claim including expenses not exceeding 20 lacs , within 1 year from date of rejection/repudiation/partial settlement of claim by the Insurer. For jurisdiction please Click here.
  • You should not have approached any other forum/court/arbitrator on the same subject matter of your claim.
  • The forum of Insurance Ombudsman does not charge any fees for filing the complaint
The Ombudsman may receive and consider complaints relating to the following:
  • Partial or total repudiation of claims
  • Delay in settlement of claims
  • Disputes relating to premiums paid/payable
  • Legal construction of the policies in so far as such disputes relate to claims.
  • Non-issue of Insurance documents.
The complaint shall be in writing duly signed by the policyholder or claimant/ legal heirs. Click here to download Complaint form.
  • Send the Complaint letter alongwith the photocopies of the supporting documents as given hereunder to the Office of Insurance Ombudsman.
  • Policy copy ( all pages of policy under which complaint is lodged)
  • Copies of all old policies for covering of Insurance since last 48 months prior to this policy if claim is rejected on grounds of pre-existing diseases/waiting period.
  • Repudiation/Denial letter/Partial settlement letter issued by the Insurance company.
  • Representation to the Grievance Redressal of Insurance Company.
  • Any other correspondence exchanged with Insurance Company & TPA.
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