The Exposure Draft of the Internal Insurance Ombudsman Guidelines, 2025, released for public consultation, proposes 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 Rs 50 lakh, according to a press release by the Insurance Regulatory and Development Authority of India on Wednesday.
Insurers may also appoint more than one Internal Insurance Ombudsman to ensure effective coverage and responsiveness, the release said.
The guidelines comprehensively lay down the eligibility criteria, tenure, independence, role & responsibilities and remuneration structure of Internal Insurance Ombudsman along with general principles to be followed by the Internal Insurance Ombudsman. The Internal Insurance Ombudsman is proposed to report to the Board or its Policyholder Protection, Grievance Redressal and Claims Monitoring Committee, with administrative reporting to the MD/CEO.
By institutionalizing this internal but independent mechanism, Irdai aims to further improve the quality of grievance handling and enhancing overall consumer confidence in the insurance sector., the regulator stated. The exposure draft is available on the Irdai website, and stakeholders can submit their comments and suggestions by Aug 17.
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