How To File A Complaint Against An Insurance Company In Consumer Court

With the expansion of the insurance sector in the last two decades and the advent of more efficient client servicing, insurance companies are expected to follow rules on everything. When you buy any insurance policy, you expect to receive top class service along with peace of mind that you’re safe. But what if your insurer denies a claim fraudulently or defaults on service? You may face several issues like delay in claim settlement, non-receipt of your policy, dispute regarding premium paid or payable, dispute as to the sum payable, few terms and conditions may throw you off gear or even a claim rejection.

 It is certainly an unpleasant situation but not an impossible one. Your best recourse is to approach the IRDA or the insurance company or even an ombudsman. But if all these steps fail, then you have to head to a consumer court for a redressal and resolution of your problem.

What is the process of filing a consumer complaint?

There is a process to be followed depending upon the monetary value of the compensation of the consumer complaint, in case of an insurance company. In fact, if the value of goods and compensation is less than Rs 20 lakh, in that case, you have to approach the district consumer forum. As opposed to this, if the value of goods and compensation is more than Rs 20 lakh but definitely less than Rs 1 crore, a case can be filed in State Consumer Dispute Redressal Forum. If it exceeds Rs 1 crore then the case should be filed in the National Consumer Commission. Unlike other court cases, you don’t necessarily need to hire the services of a legal expert or a lawyer to file a consumer complaint. In fact, you can file it directly by yourself, clearly stating the fact, circumstances and the compensation demanded. It has to be filed within two years of the deficiency of service/ defrauding by the insurer. The necessary documents for a consumer court petition include the following:

·         The most obvious fact is while filing a complaint you have to enter the name, address, description of the complainant

·         Name of the insurance company/opposite party or parties against whom the complaint is being filed.

·         Cause and facts relating to the complaint should also be mentioned like the time and place of occurrence.

·         Alongwith your complaint, you must also furnish or attach documents in support of your petition that will take the case further.  

Till some years ago, arbitrary rejection of claims was fairly common, with many depictions of such scenarios in popular culture. John Grisham’s book “The Rainmaker” is based on a large insurance company rejecting a claim. But with strong regulation being put in place and active regulatory bodies operating in most countries, the situation has changed drastically in the last 10 years. Where customers have a plethora of options to choose from, insurance companies need to have a good claim record in order to attract customers. In fact, a good claim record is one of the selling points insurance companies use in their advertising. But, even with every measure in place, some claims still get fraudulently rejected. In such a scenario, it is extremely important for consumers to take the matter to the right authorities.