Robinhood Insurance Broker Private Limited

Whom do I need to contact in case of a grievance with LIC of India?

In case the insured/policyholder has any grievance regarding services, products, or processes of LIC of India, 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, coordination, 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 involve 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

The company's service strategy is to enable the customer to avail services through multiple avenues. The avenues available to the customer are:

Grievance Redressal Officers

Grievance Redressal Officers have been designated at all levels of the organisation:

  • At the branch level: Sr/Branch Manager
  • At the divisional level: Manager, CRM
  • At the zonal level: Regional Manager, CRM
  • At the central level: Executive Director, CRM 
  • At the zonal level: Regional Manager (Pension and Group Schemes)

Policyholders can personally contact these designated officials and seek redressal of their grievances.

The respective Grievance Redressal Officers are available at their offices for personal interviews with the customers on all Mondays between 2.30 and 4.30 PM, except on holidays without prior appointment. Customers can meet the Grievance Redressal Officers on other days also with prior appointment.

The names of the Grievance Redressal Officers are displayed in the respective offices and are periodically published in local newspapers.

Claims Dispute Redressal Committees

The Corporation settles a large number of death claims every year and adopts fair practices in the matter of settlement of claims. It is not the policy of the corporation to repudiate a genuine claim. Furthering this cause, LIC pioneered the initiative of introducing an internal review mechanism in the year 1979 to give an opportunity to the claimants to appeal for review whenever a claim is repudiated. The Claims Dispute Redressal Committee is functioning at the corporate level and all eight zonal offices. The Central Office Claims Dispute Redressal Committee [CO CDRC] is functional at Central Office, Mumbai and the Zonal Office Claims Dispute Redressal Committee [ZO CDRC] is functioning in all zonal offices located at Delhi, Kanpur, Bhopal, Kolkata, Chennai, Hyderabad, Mumbai, and Patna.

The Committee consists of senior officials at the Zonal/Central Office and a retired District/High Court Judge.

Whenever a claim is repudiated, the claimant is explicitly informed of the grounds of repudiation and provided with the address of the Zonal Office Claims Dispute Redressal Committee (ZO-CDRC) to prefer his/her appeal.

If the decision to repudiate the claim is upheld by the said committee, then depending on the net claim amount, the claimant is either provided with the address of the Insurance Ombudsman or with the address of the Central Office – Claims Dispute Redressal Committee (CO CDRC).

Again, if the decision to repudiate, the claim is upheld by the CO-CDRC, the claimant is provided with the address of the Insurance Ombudsman to whom the claimant may prefer an appeal.

The internal mechanism for review of repudiated claims adopted by LIC has ensured transparency and confidence in our operations and has resulted in greater satisfaction among the claimants and policyholders.

Policyholder Councils And Zonal Advisory Boards

In all the 113 Divisional Centres, policyholders' councils have been established. Three policyholders of the area represent the interest of the policyholders and interact with the Divisional Management on consumer concerns. Similarly, at all the eight zonal centres, Zonal Advisory Boards are functioning.

Citizens' Charter

LIC has adopted a Citizens Charter, through which it reiterates its commitments to the customers. The standards for general procedures, the standards for policy servicing, the standards for easy access to information for customers and the standards for fairness in dealing with the customers have been laid down.

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

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