Procedure for making a complaint :

Any person who has a grievance against the insurer may himself or through the legal heirs make a complaint in writing to the Ombudsman within whose jurisdiction the branch or office of the insurer complained against is located.

The Complaint shall be in writing duly signed by the complainant or through his legal heirs and shall state clearly the name and address of the complainant, the name of the branch or office of the insurer against which the complaint is made, the fact giving rise to the complaint, supported by the documents, if any, relied on by the complainant, the nature and extent of the loss caused to the complainant and the relief sought from the Ombudsman.

In order that a complaint is entertained before the Ombudsman, the following conditions must be satisfied:

(a) The complainant must have first exhausted the remedies available within the insurance company for settling the grievance and approach the Ombudsman only if either the insurance company rejects the grievance or complainant not satisfied with the reply or the insurer fails to respond within one month of submission of the grievance

(b) No complaint can be preferred before the Ombudsman after one year from the date of rejection or final letter from the insurance company on the representation made by the complainant

(c) If the complainant has not preferred alternative legal remedies and the proceedings are not pending before any Court or Consumer forum