PENDENCY OF COMPLAINTS AT INSURANCE OMBUDSMAN [IO],AHMEDABAD & SUGGESTIONS

J P SHAH,

202 Velamani Residency,

9A Vrindavan Park Soc,

VADODARA GUJARAT 390008

Email ID: jpshah50@yahoo.co.in

Cell: 9924106490

___________________________________________________________________

   SENIOR CITIZEN WITH FATAL LIVER DISEASE   DATE:  15-08-2019                                                          

                                                                                                           

To,

Chairman,

Executive Council of Insurers,                                                  By email

3rd Floor, Jeevan Seva Annexe,

S. V. Road, Santacruz [west]  Mumbai 400054

email ID: inscoun@ecoi.co.in

Dear Sir,

PENDENCY OF COMPLAINTS AT INSURANCE OMBUDSMAN [IO],AHMEDABAD & SUGGESTIONS

Greeting on INDEPENDENCE DAY.

I understand per your RTI reply dated 22-07-2019 that nearly 2600 complaints are pending with Insurance Ombudsman Ahmedabad [IOA for brevity] due to vacancy of post of IOA since 21-07-2014, though there is visiting IO for few days in a month/fortnight.

2. Reckoning that IOA decides 5-7 complaints per day on an average and works for 20 days a month [excluding Sundays/Saturdays/Holidays/Leave etc], it will take nearly two years to clear the backlog. In addition there will be equal number of new complaints in these two years. Thus pendency will continue to be around 2500 equal to 2 year period against mandated 90 days as per IO rules.

3. Many of complainants may be senior citizens and this killing pendency is putting them in financial and mental tension at the fag end of their lives. Some will unfortunately not get decision/award during their life time. Thus the very purpose of IO scheme of speedy and cost-effective disposal of complaints against insurance companies is mercilessly butchered, more so for senior citizen insureds in Gujarat. Most complaints will get time barred for complaints under CPA 1986/2019 [if decision is not satisfactory] putting further loss to insureds for no fault on their part and undue gain to insurance companies.

4. Such pendency also undermines Central and State Govt’s Insurance Covers to masses under welfare measures initiated by Hon’ble Prime Minister.

5. This being pitiable condition of IOA, while I am sure ECOI and IRDAI are capable to resolve it in the interest of insureds, I humbly suggest that even after posting permanent IOA latest by Aug 2019-end, the visiting IO should continue for few days in a week/fortnight at Ahmedabad till pendency is reduced to 180 days if not mandated 90 days as per IO Rules.

6. Alternatively, I suggest that complaints of senior citizens should be separately listed for priority hearing and disposal by IOA and 1 or 2 days in a week/fortnight should be exclusively reserved for hearing and disposal of complaints of insureds who are senior citizens at the time of filing. The life time of senior citizens is fast running out.

7. Please take suitable action urgently specially for AIO.

8. To make IO Scheme more user friendly and effective, I also suggest:

a] appeal mechanism like Banking Ombudsman,

b] on line filing of complaints and video or audio hearing on mobile like CIC/some SICs [Digital initiative of Central Govt and ease of living]. CPA will fully go online shortly as per new CPA 2019 BILL.

c] Provision of Internal Ombudsman [as prevailing in banks under RBI directives] for all Insurance Companies. This is successful in Banking Sector.

d] Circuit benches at various places other than State capitals.

e] President or Chairman of two leading NGOs working in consumer protection be included in Council of ECOI, as there is no representation of insureds at present in the Council.

I hope you will respect principle of “Ease of Living” as pronounced in today’s independence speech by hon’ble Prime Minister. This was also quoted by hon’ble Finance Minister in her budget speech of 2019.

Thanking you,

Yours faithfully,

J P SHAH

Copies by email to:

1. Insurance Regulatory and Development Authority of India

 Gachibowli,  Hyderabad – 500032        

e-mail: irda@irda.gov.in –with a request to kindly intervene in the interest of insureds, specially senior citizens

2. Secretary, Dept of Consumer Affairs, Ministry of Consumer Affairs, food and public distribution, GoI, New Delhi Email: secy-ca@nic.in

--Consumers of Insurance Cos are adversely affected.

3.  Secretary, Dept of Financial Services, Ministry of Finance, GoI, New Delhi  Email: secy-fs@nic.in  -Please expedite solution.

4.  Secretary,  Dept of Social Justice and Empowerment, Ministry of Social Justice and empowerment, GOI, New Delhi  email: secywel@nic.in               Please intervene as senior citizens  are affected adversely

5. Consumer Education and Research Centre, Thaltej, Ahmedabad-380054

EMAIL: cerc@cercindia.org