Consumer Affairs

Consumer Affairs


Functions and Responsibilities of Consumer Affairs Department

The Consumer Affairs Department of the Insurance Regulatory and Development Authority of India looks into complaints/grievances from policyholders and takes up the grievances with the respective insurers for redressal.

Prospects and policyholders are advised to first file their complaints with the respective insurance companies. If they do not receive a response from the insurer within a reasonable period of time or are dissatisfied with the response of the company, they may approach the Consumer Affairs Department of the IRDAI. IRDAI shall facilitate re-examination of the complaint and resolution by the insurance company.

What’s New

01-12-2019

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FAQs

Insurance Regulatory and DevelopmentAuthority (IRDA) was set up as an autonomous body under the IRDA Act, 1999 to protect the interests of policyholders and to regulate, promote and ensure orderly growth of the insurance industry. Redressal of grievances is one of the key components of IRDAI’s efforts in protection of interests of proposers and policyholders.

Yes. The IRDAI has mandated insurers to have in place a board approved policy which shall contain among other matters, the matter pertaining to service parameters including turnaround times for various services rendered. Insurers are also required to have an effective Grievance Redressal Mechanism and IRDAI has issued guidelines for Redressal of grievances so as to ensure that the complaints are resolved in a time bound and efficient manner.

Grievance/compliant has been specifically defined in Regulation 4(4) of the Insurance Regulatory and Development Authority of India ( Protection of Policyholders’ Interests) regulations, 2017 which reads as follows:

“Complaint” or “Grievance” means written expression (includes communication in the form of electronic mail or other electronic scripts), of dissatisfaction by a complainant with insurer, distribution channels, intermediaries, insurance intermediaries or other regulated entities about an action or lack of action about the standard of service or deficiency of service of such insurer, distribution channels, intermediaries, insurance intermediaries or other regulated entities; Explanation: An inquiry or request would not fall within the definition of the “complaint” or “grievance”.

An insurance company is required to resolve a grievance within two weeks of its receipt weeks of its receipt.

If a customer is unhappy with an insurance company or an intermediary associated with the company, he should approach the Grievance Redressal Officer of the company first and give the complaint. Complaint is to be given in writing along with the necessary support documents.

 IRDAI launched the Integrated Grievance Management System (IGMS) in April 2011. IGMS is a comprehensive solution which not only has the ability to provide a centralized and online access to the proposer or policyholder but also provides for complete access and control to IRDAI for monitoring market conduct issues of which proposer or policyholder’s grievances are the main indicators. It is also the central repository of industry-wide insurance grievances’ data.


 IGMS has the ability to classify different complaint types based on pre-defined rules. The system has the ability to assign, store and track unique complaint IDs. It also sends intimations to various stakeholders as required, within the workflow. The system has defined target Turnaround Times (TATs) and measures the actual TATs on all complaints. IGMS sets up alerts for pending tasks nearing the laid down Turnaround Time. The system automatically triggers activities at the appropriate time through rule based workflows. 


Proposers or Policyholders who have grievances should register their complaints with the Grievance Redress Channel of the Insurance Company first. If they are not able to access the insurance company directly for any reason, IGMS provides a gateway to register complaints with insurance companies and track their status. A complaint registered through IGMS will flow to the insurance company’s system as well as the IRDAI repository. 

 IRDAI Grievance Call Centre was launched on July 20,2010 as a true alternative channel for prospects and policy holders with comprehensive tele functionalities. The call centre serves as a toll free, 12 hours X 6 days service platform, from 8 AM to 8 PM, Monday to Saturday. The services are offered not only in Hindi and English but also in other major Indian languages. The toll free number of the call centre is 155255/1800 425 4732 and is serving as an inexpensive, expeditious and simple method of registering complaints, ascertaining their status and escalating them to IRDAI.

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