Grievance redressal

If something has gone wrong — an answer you never got, a document that never arrived, a policy that is not what you understood it to be, a claim that has stalled, or the way you were dealt with — there is a defined route for complaining about it. It has four steps, it does not end with us, and nobody here can stop you moving to the next one.

This page explains where a complaint goes and who can decide it. It is information, not advice, and it does not change the terms of your policy.

What should you do if you have a complaint?

Put it in writing to the agent first, with your policy or application reference and what you want done about it. If that does not resolve it, take it to the insurer, which owns everything to do with the policy itself. If that fails, register it with IRDAI through the Bima Bharosa portal, and after that with the Insurance Ombudsman.

The steps are set out in the order they are usually taken, and the later ones expect you to have tried the earlier ones. One thing about that order is worth knowing before you rely on it. What the Ombudsman requires is that you complained to the insurer — not that you registered with IRDAI. Step 3 is worth doing, and step 4 does not depend on it. There is also a deadline for going to the Ombudsman, and it runs from the insurer's reply, so if the Ombudsman is where you are heading, read that deadline at source before you spend time at step 3. Using one step does not cost you the next.

The escalation path, step by step

1. Step 1 — Raise it with the agent

   The first point of contact is the licensed agent. This is the right step for anything this practice itself did or failed to do: what you were told, what was explained to you, what was sent, what happened to your paperwork, and how you were treated.

   Dr. Sonali Walia
   [email protected]
   +91 87968 39997

   Write it down rather than only saying it on a call — a written complaint is the one that can be tracked, forwarded and evidenced later. Put in as much of this as you have:

   Your policy number, or your application reference

   If you do not have either, the name you applied in and the rough date are usually enough to find you.

   What happened, in order, with dates

   Who said what, and when. Dates matter more than adjectives, particularly once a complaint reaches the insurer or the Ombudsman.

   What you want to happen

   A correction, a document, an explanation, a call back, a decision looked at again. A complaint that names the outcome it wants is far easier to act on than one that only registers that you are unhappy.

   Anything you already have in writing

   Emails, letters, messages, receipts, acknowledgements. Send copies and keep your originals.

   What to expect. We will acknowledge your complaint in writing and tell you what we are doing with it. If it is really about the policy rather than about us, we will say so and help you put it to the insurer, instead of leaving you to work that out.

   If it is not resolved, or you are not satisfied with the answer, go to step 2.

2. Step 2 — Take it to the insurer

   Your policy is a contract between you and the insurer. It is not a contract with us. So a complaint about the policy itself belongs with the insurer: how it was underwritten, what it does or does not cover, how it has been serviced, or how a claim has been decided. The insurer made those decisions, and the insurer is bound by the contract.

   The insurer for every policy placed by this practice is Kotak Mahindra Life Insurance Company Limited.

   IRDAI's regulations (opens an external site in a new tab) require every insurer to run a grievance redressal mechanism with a designated grievance redressal officer responsible for it. The insurer's own website is where its current complaint addresses and internal escalation route are published, so take them from there rather than from us.

   The insurer's website ↗ (opens an external site in a new tab)

   You can go to the insurer directly. You do not need our permission, you do not have to route it through us, and you do not have to tell us you are doing it. A complaint about how an agent dealt with you can also be made to the insurer, because an agent is appointed by, and answerable to, the insurer.

   If it is not resolved, or you get no reply within a reasonable period, go to step 3.

3. Step 3 — Register it with IRDAI on Bima Bharosa

   Bima Bharosa is the regulator's own online complaints portal, run by the Insurance Regulatory and Development Authority of India (IRDAI). You can register a complaint there yourself and track its status. It is the right step once the insurer has failed to resolve your complaint, or has not responded to it within a reasonable period.

   Bima Bharosa — IRDAI's grievance portal ↗ (opens an external site in a new tab)

   IRDAI also runs a grievance call centre for policyholders who would rather speak to a person than file a complaint online. The current number and its hours are published on the portal and on IRDAI's own site. They are deliberately not reprinted here: a wrong number on a page like this one is worse than no number at all.

   IRDAI ↗ (opens an external site in a new tab)

   If it is still not resolved, go to step 4.

4. Step 4 — Take it to the Insurance Ombudsman

   The Insurance Ombudsman is an independent forum for policyholder complaints, constituted under the Insurance Ombudsman Rules, 2017 and administered by the Council for Insurance Ombudsmen. It exists precisely so that a policyholder does not have to go to court to be heard.

   Three things are worth knowing before you get there:

   • It costs you nothing. The Ombudsman does not charge a complainant a fee, and you do not need a lawyer to bring a complaint.
   • An award binds the insurer. An award made by the Ombudsman is binding on the insurer under the Insurance Ombudsman Rules, 2017 (opens an external site in a new tab), which also set the period within which the insurer must comply with it and confirm that it has.
   • There are conditions. You are expected to have complained to the insurer first and given it time to reply, there is a deadline for bringing the complaint after that, and there are limits on the kind and the size of complaint the Ombudsman can take. The complaint to the insurer is the one that has to have happened: a complaint registered with IRDAI is not a substitute for it, and is not something the Ombudsman requires you to have done first. These rules are amended from time to time, so read them at source.

   The offices are territorial, and there is an office whose jurisdiction covers Delhi. Find it, and the current eligibility rules, on the Council's own site rather than from any summary of ours.

   Council for Insurance Ombudsmen — offices and rules ↗ (opens an external site in a new tab)

   Whether your complaint goes to the Ombudsman is your decision alone. It is not ours and it is not the insurer's.

The four steps at a glance

What we will and will not do about a complaint

We will:

• help you write the complaint down, and find your policy or application reference if you have lost it
• tell you honestly which step your complaint belongs at, including when that step is not us
• send it on where it needs to go, and give you a copy of exactly what was sent
• keep a record of it, and tell you plainly if we got something wrong

We will not:

• obstruct, delay, discourage or lose a complaint, at any step
• ask you to withdraw one, or to accept an outcome you are not satisfied with
• require you to come through us before going to the insurer, IRDAI or the Ombudsman — you never need our involvement to escalate
• charge you anything for making or escalating a complaint

Can the agent decide the outcome of a claim?

No. We distribute insurance; we do not underwrite it. Whether a claim is admitted, and on what terms, is decided by the insurer under the policy contract. We can pursue it, explain what we are told, and help you escalate a decision you disagree with — we cannot overturn one, and anyone who tells you otherwise is describing a power that does not exist.

Why there are no timeframes on this page

Response deadlines, limitation periods and eligibility limits are set by regulation and by each insurer's published grievance policy, and they are amended from time to time. Rather than print a number here that may be out of date by the time you read it, every step above links to the body that owns the rule. If a timeframe matters to your complaint, take it from the regulator, the Ombudsman or the insurer's own current statement — and ask us in writing if you want help finding it.

Related pages

Some complaints have a route of their own. These are the ones people arrive at this page looking for.

• Refund and free-look — if a policy has just been issued to you and it is not what you understood you were buying, there is a window in which you can return it. Read that before you complain: the window is short, and a complaint does not stop the clock.
• Privacy Policy — a complaint about how your personal data was handled runs a different route, under the data protection law rather than the insurance regulator. That page sets it out.
• IRDAI disclosures — the registration code to quote in a complaint, who this agency is appointed by, and how it is paid.
• Terms of Use — the terms this website is provided on, and what does and does not put you on risk.