Customers can File Online Complaints About Health Insurance Companies With IRDA

Online complaints about health insurance companies can now be filed with the Insurance Regulatory Development Authority (IRDA) at http://www.igms.irda.gov.in.

The Integrated Grievance Management System (IGMS) of IRDA facilitates online registration of policyholders' complaints and helps track their status. One can avail of further assistance on a toll-free number 155255.

This is a step forward from last year, when IRDA had opened a channel to accept complaints on insurance policies, in case the insurer's response wasn't satisfactory. Now, one can register a complaint as well as check its status later.

What should one do in case of a complaint against an insurer?

One should first approach the insurer's Grievance Redressal Mechanism as spelt out in the insurance policy document (link to the insurers' grievance mechanism is available in http://www.igms.irda.gov.in at List of Insurers).

What happens if there is no response from the insurer?

In case the complaint is not fully attended to by the insurer within 15 days of its being lodged, the customer may use the IGMS for escalating the complaint to IRDA.

How to use the IGMS:

A policyholder can make optimum use of this system by giving accurate information about the complaint like the policy number, name of the insurer, complainant's contact details, etc. One must keep the policy document ready while registering the complaint online.

The Complaint Registration Process involves two simple steps:

Step 1 : Registration of the customer by entering his/her credentials

Provide personal details such as name, date of birth, gender, contact number and address. Enter the permanent account number (PAN), voter ID number, or the passport number.

Step 2 : Using registered credentials to register complaints/view their status

File a complaint against an insurer, broker, unregistered party or intermediary. Choose the relevant branch code from the list provided on the website and provide the policy details. Choose the appropriate options for type of policy, type of complaint and description of the complaint. An IRDA token number and a reference number will be generated at the time of registration of the complaint.

Once registered, complaints can be viewed or edited. The status of the complaint can also be seen. The status could be: new, acknowledge, pending, attended to or closed. Based on the complaint registration date, the system will calculate the age of each complaint and show the IRDA token number and a column for turnaround time (TAT) tolerance that displays the tolerance of a particular complaint against the number of days it stays pending.

If the account is more than 10 days old, the colour will be green, if it is more than 30 days old, it will show yellow and for more than 60 days, the colour is orange.

Based on the complaint registration date and TAT, the screen also shows the expected date of disposal of the complaint.

Source: Medindia