INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY (IRDA) Responsible for addressing complaints filed by policy holders.
COMMON PROBLEMS 1.Incomplete documents 2.Delay 3.Inadequate briefing 4.Absence of speaking order
Need for Grievances Redressal 1.Provides transparency and confidence in the operations and thereby greater satisfaction. 2.Uniform and consistent application of rules.
VALID OBJECTIONS 1.Grievance/Customer Complaints Cell not approached in the first instance. 2.Above approached but a reasonable time not elapsed.
SPEAKING ORDER A decision that shows application of mind. Indicates reason.
Effective Presentation 1.Complete documents. 2.Point out policy (applicable). 3.Show deficiency/untenability of complaint/claim. 4.Be objective and fair. 5.Give speaking order
USEFUL POINTS 1.Select a list of competent counsels of proven integrity. 2.Thorough briefing of counsels. 3.Be present in court when the matter is taken up.
INCONTESTABILITY CLAUSE The insurer will not be able to contest the statements contained in the application.
Take corrective in-house action to change procedures & system.
1.Create a Legal Cell 2.Identify suitable and experienced manpower. 3.Stock requisite publications and law literature.
ILLUSTRATIONS 1.Compulsion to execute an unconditional discharge voucher. 2.Compulsion on the insurer to receive whatever amount is offered.
APPEAL 1.Examine the order. 2.Point out weak areas of orders that can be contested. 3.Enumerate grounds for appeal. 4.Show precedents, if any, in support of contention for appeal. 5.Filing of Appeal within stipulated time period.
TIMELY COMPLIANCE OF JUDICIAL ORDER 1.To avoid contempt. 2.To avoid penal rate of interest.