Insurance Ombudsman
A free, independent forum for policyholders whose complaint the insurer rejected or did not answer within a month.
The Insurance Ombudsman is the step after the insurer, for disputes about claims, premiums or policy terms. It costs nothing, and it must decide within three months of getting everything it needs from you. Always complain to the insurer first. Our guide to a rejected health insurance claim walks through the full ladder.
Questions people ask
When can I go to the Insurance Ombudsman?
After you have complained to the insurer in writing, and the insurer rejected it, did not reply within one month, or gave a reply you are not satisfied with. You must file within one year of that reply, or of the one-month mark if there was no reply, under the Insurance Ombudsman Rules, 2017.
Is there a fee, and how much can the Ombudsman award?
There is no fee. The Ombudsman can award compensation up to 50 lakh rupees, including expenses, and not more than the loss you actually suffered. Complaints can be filed online at cioins.co.in.
What if the insurer ignores the Ombudsman's award?
The insurer must comply within 30 days of receiving the award. Under IRDAI's 2024 health master circular, if it does not, it must pay the complainant 5,000 rupees a day as a penalty, on top of interest.
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