Insurance Ombudsman

The Insurance Ombudsman scheme was created by Government of India for individual policyholders to have their complaints settled out of the courts system in a cost-effective, efficient and impartial


There are 12 Insurance Ombudsman in different locations and you can approach the one having jurisdiction over the location of the insurance company office that you have a complaint against.

You can approach the Ombudsman with complaint if:

  • You have first approached your insurance company with the complaint and
    • They have not resolved it
    • Not resolved it to your satisfaction or
    • Not responded to it at all for 30 days
  • Your complaint pertains to any policy you have taken in your capacity as an individual and
  • The value of the claim including expenses claimed is not above Rs 20 lakh

Your complaint to the Ombudsman can be about:

  • Any partial or total repudiation of claims by an insurer
  • Any dispute about premium paid or payable in terms of the policy
  • Any dispute on the legal construction of the policies as far as it relates to claims
  • Delay in settlement of claims
  • Non-issue of any insurance document to you after you pay your premium
  • The settlement process


The Ombudsman will act as counsellor and mediator and 

  • Arrive at a fair recommendation based on the facts of the dispute
  • If you accept this as a full and final settlement, the Ombudsman will
  • Inform the company which should comply with the terms in 15 days


  • If a settlement by recommendation does not work, the Ombudsman will:
  • Pass an award within 3 months of receiving the complaint and which will be
    • A speaking award with the detailed reasoning
    • Binding on the insurance company but
    • Not binding on the policyholder
  • The Ombudsman can also award an ex-gratia payment

Once the Award is passed 

  • You have to accept the award in writing and the insurance company has to be informed of it within 30 days and
  • The Insurance company has to comply with the award in 15 days after that.