Saturday, June 16, 2012

HOW TO APPROACH INSURANCE OMBUDSMAN


Also at https://www.box.com/s/8ce7e60e3e02ca045335
                                               
                                                           COMPLAINT PETITION

BEFORE HON’BLE INSURANCE OMBUDSMAN AT __________

Address of Office of Insurance Ombudsman:
_______________________________________________________________

Date: _________                                                                 By Registered Post AD
                                                             
Being aggrieved by no decision/ full or part repudiation of claim, I submit this complaint for kind decision.

01. Name and address of complainant with mobile No. and email ID [if any] :

Mention your details


02. Name and address of Insurance Company with fax/phone/email ID:



03. Details of policy:

Type of Policy _________

No. of policy: __________

Validity from _______ to ________

Policy since: _______ [mention date of commencement of first policy]

04. Details of Claim:

Claim Amount: Rs.__________ [Rs. ___________________________only]

Claim submission date ________

Claim relating to: ________

Claim No. [Allotted by insurance co] if any

05. Cause of Complaint:

[Mention here how claim has been rejected]



06. Submission of Complainant:

[Mention why you think claim should have been paid]

07. Prayers and Relief:

a. Claim of Rs. ________[ in words Rs. __________] be kindly ordered to be paid to complainant with interest at ____ p.a. from  date of lodging claim to date of payment.

b. Compensation of Rs. _____ towards expenses and mental agony be ordered to be paid.

c. Insurance Company be imposed exemplary penalty for improper repudiation, non-conveying decision, delay in conveying decision on claim, violating IRDA directives and not honoring averments of higher judiciary on the matter of such claims.

d. The Hon’ble Insurance Ombudsman be pleased to pass such other orders as deemed fit in the interest of justice, fair play and equity.

08. Declaration:

Complainant hereby states that the information and particulars given above are true to the best of his knowledge and belief. He also declares that this matter is not previously filed with any commission or Court or tribunal or authority.

09. Attachments:

Self attested photocopies of: a] Policy, b] Claim form with its enclosures,   c] All letters of Insurance Co or TPA d] Complaint made to insurance company/TPA by complainant giving 30 days minimum time to settle claim.                      

X
Signature of Complainant

Copy to [without attachments, since same are with it] by Regd AD post:

Branch Office of Insurance Company which issued policy
________________________________________________________________

Guidelines: 1. Please visit http://www.gbic.co.in/notifications.html specially  clauses 13 to 18.  For address etc please visit www.gbic.co.in  

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