Clipped from: https://www.thehindubusinessline.com/news/irdai-moots-internal-insurance-ombudsman-for-insurers/article69850280.ece
Framework will mandate impartial resolution of complaints and improve fairness to the customer
The insurance regulator has proposed the establishment of an independent and impartial review mechanism within insurers to address unresolved or escalated complaints in a fair, transparent and time-bound manner | Photo Credit: scyther5
With a view to strengthening policyholder protection and enhancing trust in the insurance ecosystem, the Insurance Regulatory and Development Authority of India (IRDAI) will soon be introducing Internal Insurance Ombudsman in all insurance companies except reinsurers.
According to the exposure draft of the Internal Insurance Ombudsman Guidelines 2025, the insurance regulator has proposed the establishment of an independent and impartial review mechanism within insurers to address unresolved or escalated complaints in a fair, transparent and time-bound manner.
Applicable to all insurers (except reinsurers) with more than three years of operations, the framework mandates the appointment of an Internal Insurance Ombudsman to address complaints involving claims up to ₹50 lakh. Insurers may also appoint more than one Internal Insurance Ombudsman, with well-defined jurisdiction, to ensure effective coverage and responsiveness.
“The proposed Internal Insurance Ombudsman should functionally report to the Board or its Policyholder Protection, Grievance Redressal and Claims Monitoring Committee, with administrative reporting to the MD/CEO. By institutionalising this internal but independent mechanism, IRDAI aims to further improve the quality of grievance handling and enhance overall consumer confidence in the insurance sector,’‘ said IRDAI in a release.
Welcomes suggestions
All stakeholders can submit their comments and suggestions on or before August 17. According to Parag Raja, MD & CEO, Bharti AXA Life Insurance, the IRDAI’s move to institutionalise an internal insurance ombudsman mechanism represents a significant shift in the existing in-house grievance redressal structures to a more independent decision-governing body.
“By mandating independent governance oversight and direct accountability to the Board or a Policyholder Protection, Grievance Redressal and Claims Monitoring (PPGR & CM) Committee, this framework will mandate impartial resolution of complaints and improve fairness to the customer, ensuring greater trust in the industry,’‘ he said.
Published on July 24, 2025
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