Can you go to the Ombudsman?
- You have first complained to the insurer in writing.
- The insurer rejected the complaint, did not reply within a month, or you are not satisfied with its reply.
- You file within one year of the insurer’s reply, or of the month passing without one.
- The amount in dispute is up to ₹50 lakh.
- The same dispute is not already before a court, consumer commission or arbitrator.
Which office to approach
There are 17 Insurance Ombudsman offices across India. You can file with the office that covers the insurer’s branch you dealt with, or the one that covers where you live.
How to file, step by step
- Keep your complaint to the insurer ready, with its reply or proof that a month has passed.
- Fill the complaint form. It is available on the Council for Insurance Ombudsmen website, cioins.co.in, where you can also file online.
- Attach your documents: the policy, claim papers, the rejection or settlement letter, your complaint to the insurer and its reply.
- State the relief you want, with the exact amount, and keep the acknowledgement.
What happens next
- The Ombudsman first tries to settle the dispute by mediation.
- If that fails, it hears both sides, often online, and passes an award within three months of receiving everything it needs.
- The award binds the insurer, which must comply within 30 days. It does not bind you: if you do not accept it, you can still go to a consumer commission or court.
How Mediclaimswala helps
We prepare the complaint, attach the right evidence in order, and support you through the hearing. Filing with the Ombudsman is free, and you can do it yourself; we help people who want an experienced hand.
Last reviewed: . This page is general information based on IRDAI rules as of the date above. It is not legal advice. Policy wordings differ, so we check what applies to your case.