Robinhood Insurance Broker Private Limited

Whom do I need to contact in case of a grievance against Apollo Munich Health Insurance?

In case the insured/policyholder has any grievance regarding services, products, or processes of Apollo Munich Health Insurance, they may approach the grievance redressal cell. This detailed FAQ will mention all the steps involved as well as the contact details.

Complaints that would require immediate reporting to the Compliance Department include complaints pertaining to the Sales conduct of agents, brokers, and other sales intermediaries. These complaints could be regarding any of the following:

  • Mis-selling
  • Mis-representation
  • Rebating
  • Misappropriation of funds
  • Fraud
  • Forgery
  • Lack of service
  • Theft
  • Commission schemes / sharing
  • Fictitious policies
  • Employee fraud
  • Vendor fraud
  • Administration, control, co-ordination, and reporting of customer complaints received through regulatory agencies.
  • Allegations of financial irregularities by any person who has a responsibility within the company and that involves money, credit, or any other property of the company or its clients
  • Any complaint where there is a stated or implied threat of litigation
  • Any other matter as may be defined by Compliance from time to time

Step 1

The insured can register a complaint through the following modes:

Vision Paper on Grievance Handling

  • As the company is dealing with human lives, there will always be a difference between perspective and delivery
  • The company strictly believes that customer satisfaction leads to long-term relation and business

Philosophy

To handle customer grievances, Apollo Munich Health intends to implement a system where they target:

  • Document issuance ratio of 100%
  • Non-suit claim settlement ratio of 100%

The Apollo Munich Grievance Cell has representatives in all regional and branch offices. The customer can approach this Cell every Friday from 3 to 4 PM in any of the offices. The company's representatives have been trained to handle your grievances with empathy and concern.

Please note the following:

  • All grievances will be acknowledged within 3 days
  • All couriers and fax will be answered/acknowledged from the respective regional/branch office
  • All grievances from walk-in customers (only Fridays) will be acknowledged there and then
  • Based on the type of grievance, Apollo Munich Health Insurance will try to provide a solution within 2 weeks
  • In case there is no revert to your query in 2 weeks, the customer will have the right to approach the head of the Grievance Cell directly
  • The head of the Grievance Cell will acknowledge the receipt of the grievance within 3 days of receipt
  • The head of the Grievance Cell will respond to the grievance with a possible solution within 2 weeks from the acknowledgement of the griecance
  • In case of no revert or the insured is not satisfied with the reply, he/she has the right to approach other forums, such as IRDAI, Insurance Ombudsman, consumer court, a court of law, and so on.

In case you are not satisfied with the information provided by the insurance company or if there is no response from the insurance company, then you may further contact the Grievance Redressal Cell of the Consumer Affairs Department of IRDA or the Insurance Ombudsman.

IRDA Grievance Details

  • IRDA Grievance toll-free number: 155255
  • Fax number : 91 40 6678 9768
  • Email ID: complaints@irda.gov.in
  • You can also register your complaint online at http://igms.irda.gov.in
  • Address for communication for complaints by fax/paper:
    Consumer Affairs Department
    Insurance Regulatory and Development Authority
    9th Floor, United India Towers,
    Hyderguda, Basheerbagh,
    Hyderabad – 500 029
    Telangana

In the unlikely event that the policyholder is not happy with the resolution provided by the company, they may approach the Insurance Ombudsman located in their region. Some relevant information:

  • The office of the Insurance Ombudsman has been established by the Government for the redressal of any grievance in respect of life insurance policies.
  • In case the insured/policyholder is not satisfied with the decision/resolution of the company, they may approach the Insurance Ombudsman of their state or an appropriate judicial/quasi-judicial authority having jurisdiction over the matter for redressal of your grievance.
  • Details related to the Insurance Ombudsman have been provided in the policy documents.

The insured/policyholder may approach the Insurance Ombudsman if the grievance pertains to:

  • Insurance claims that have been rejected or any dispute on the legal construction of the policy
  • Delay in settlement of claims
  • Dispute with regard to the premiums
  • Non-receipt of the insurance documents

The complaint should be made in writing and be duly signed by the complainant or his/her legal heirs with full details of the complaint and the contact information of the complainant.

The address of the Insurance Ombudsman may be obtained online at www.irdaindia.org.in.

As per Provision 13(3) of the Redressal of Public Grievances Rules, 1998, the complaint to the Ombudsman can be made:

  • Only if the grievance has been rejected by the grievance redressal machinery of the insurer
  • Within a period of one year from the date of rejection of the insurer
  • If it is not simultaneously under any litigation

Also read: How do I cancel my Apollo Munich Health Insurance policy?

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