Kathmandu. The Insurance Regulatory and Development Authority of India (IMA) has proposed to appoint an internal insurance ombudsman for the insurer to resolve the dispute related to claims up to Rs 5 million.
Issuing the draft Internal Insurance Ombudsman Guidelines, 2025, the regulator has proposed to set up a free and fair review mechanism within insurers to address unresolved or increased complaints in a fair, transparent and time-bound manner.
According to The Asian Insurance Post, it is proposed to apply to all insurers (except reinsurers) that have operated for more than three years. The appointment of an internal insurance ombudsman will be made mandatory to address disputes related to claims of up to Rs 50 lakh.
Insurers can appoint more than one internal insurance ombudsman, which has well-defined jurisdiction, to ensure effective risk-bearing and accountability. The regulator has requested to submit suggestions in the draft by August 17.
The proposed guidelines include the eligibility criteria, tenure, independence, role and responsibilities and remuneration structure of internal insurance ombudsmans, as well as general principles to be followed by them.
The regulator aims to further improve the quality of grievance management and increase consumer confidence in the insurance sector by institutionalizing an internal but independent mechanism.
