GBIC Governing Body of Insurance Council Procedure Complaint Insurance Ombudsman

Organisation : Governing Body of Insurance Council GBIC
Facility : Procedure To Lodge A Complaint With Insurance Ombudsman

Website : http://ecoi.co.in/

How To Submit GBIC Ombudsman Complaint?

The Governing Body of Insurance Council (GBIC) has been established under Redressal of Public Grievances Rules 1998, to set-up and facilitate the Institution of Insurance Ombudsman in India.

Related / Similar Facility : IRDA Insurance Ombudsman Scheme

The Governing Body of Insurance Council consists of one representative each from all insurance companies; the representative is required to be either the Chairman or Managing Director or a Director of the company represented.

Objective of RPG Rules (1998) – The objective of these Rules are to resolve all complaints relating to settlement of claim on the part of insurance companies in cost effective, efficient and impartial manner.

Procedure of GBIC Ombudsman Complaint

If you have an Insurance Policy on personal lines and have a grievance against an insurance Company complaint can be filed by Policyholder or claimant/legal heirs
** Please write to the Grievance Redressal Officer of the Insurance Company . Click here for contact details of Grievance Redressal Officers, GRO of all Insurance Companies.
** The insurance company should deal with your complaint within 30 days.
** If you are unhappy with the solution or if there is no response to your complaint from the GRO for 30 days, then you can approach the Office of Insurance Ombudsman as per jurisdiction for value of the claim including expenses not exceeding 20 lacs , within 1 year from date of rejection/repudiation/partial settlement of claim by the Insurer. For jurisdiction please Click here.
** You should not have approached any other forum/court/arbitrator on the same subject matter of your claim.
** The forum of Insurance Ombudsman does not charge any fees for filing the complaint

The Ombudsman may receive and consider complaints relating to the following:
** Partial or total repudiation of claims
** Delay in settlement of claims
** Disputes relating to premiums paid/payable
** Legal construction of the policies in so far as such disputes relate to claims.
** Non-issue of Insurance documents.

The complaint shall be in writing duly signed by the policyholder or claimant/ legal heirs. Click here to download Complaint form.

Send the Complaint letter alongwith the photocopies of the supporting documents as given hereunder to the Office of Insurance Ombudsman.
** Policy copy ( all pages of policy under which complaint is lodged)
** Copies of all old policies for covering of Insurance since last 48 months prior to this policy if claim is rejected on grounds of pre-existing diseases/waiting period.
** Repudiation/Denial letter/Partial settlement letter issued by the Insurance company.
** Representation to the Grievance Redressal of Insurance Company.
** Any other correspondence exchanged with Insurance Company & TPA.

Address:
GOVERNING BODY OF INSURANCE COUNCIL,
3rd Floor, Jeevan Seva Annexe,
S. V. Road, Santacruz (W),
Mumbai – 400 054.

FAQ On GBIC Ombudsman Complaint

Here are some frequently asked questions (FAQ) about GBIC Ombudsman Complaint:

What is the GBIC Ombudsman?
The GBIC Ombudsman is an independent body that was set up to help resolve disputes between policyholders and insurance companies. The Ombudsman can investigate complaints about insurance claims, service, and other issues.

How do I file a complaint with the GBIC Ombudsman?
To file a complaint with the GBIC Ombudsman, you will need to visit the GBIC Ombudsman website and fill out an online complaint form. You will need to provide the following information:
** Your name and contact information
** The name of the insurance company
** The policy number
** A brief description of the complaint

What happens after I file a complaint with the GBIC Ombudsman?
The GBIC Ombudsman will review your complaint and contact the insurance company. The Ombudsman will try to resolve the complaint through mediation. If mediation is unsuccessful, the Ombudsman will issue a decision. The decision of the Ombudsman is binding on both the policyholder and the insurance company.