Insurance companies should also have a system and procedure for receiving, registering and disposing of grievances in their offices. They should also send a written acknowledgement to the complainant within three working days of the receipt of the grievance. The acknowledgment should not only contain the name and the designation of the officer who will deal with the case but also the time taken for resolution of disputes.
The insurer should resolve the grievance within two weeks of the receipt and send a letter of resolution. If the dispute is not resolved in two weeks, the company should send a written response to the complainant offering redress or rejecting the complaint, also giving reasons for doing so.
The insurer should also inform the complainant about how he or she may pursue the complaint, if dissatisfied. The complaint can be regarded as closed if the complainant does not respond to the insurer within eight weeks of the company’s written response. Irda stated that any failure on the part of the insurers to follow the above procedures and time frames would attract penalties.
The regulator also emphasised that it was necessary for insurers to have automated systems that would enable online registration and tracking of status of grievances. The system should be integrated seamlessly with the authority’s system.
Besides publicising its grievance redressal procedure and ensuring that it was specifically made available on its website, an insurance company should have a system to receive and deal with all kinds of calls, including voice and e-mail relating to grievances, said Irda.