Department of Management- Customer Grievance Handling Handling Customer Grievances Grievance Redressal Systen Customer Cell Grievance Redressal Officer DPG Insurance Ombudsman Consumer Protection Act Complaint Cell Grievance Redressal Officer Insurance Ombudsman

1. TRINITY INSTITUTE OF PROFESSIONAL
STUDIESSector – 9, Dwarka Institutional Area, New Delhi-75
Affiliated Institution of G.G.S.IP.U, Delhi
BBA (B&I)
Practices of Life Insurance
(18305)
Customer Grievance Handling
By: Ratika Malhotra

2. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Handling Customer Grievances
With the growth of consumerism & influence of
consumer welfare legislation has made the
customer very important person.
The insurance industry is likely to think more of the
customer, his needs, his preference and the
solutions necessary to serve the customer.
Insurance policy is a long term contract with
constant face to face interaction between the
customer and insurer. In view of this customer
grievance bound to arise.

3. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Grievance Redressal Systen
• Customer Cell
• Grievance Redressal Officer
• DPG
• Insurance Ombudsman
• Consumer Protection Act

4. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
In each tier of the organization complaint
handling cells are functioning. They receive
the complaints, register them with a unique
identification number, follow up the matter
with the operating units and try to give a
satisfactory reply and compliance to the
complaint.

5. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Grievance Redressal Officer (GRO)
At each tier of office a senior officer is
designated as GRO. Branch manager at
branch, marketing manager at division,
executive director at central office are
designated to handle grievances. These
officers are required to be available in office
on any one convenient day of the week to
receive the customer grievances.

6. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Beside these formal organization arrangements
the public are free to take recource to
government redressal mechanism at DPG.
DPG refer such complaints to the insurer
seeking insurer prompt redressal to grievances.

7. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
• The consumer dispute redressal agencies are quisi-
judicial machineries. The objective of the Consumer
Protection Act is to protect the interest of consumer
by providing for simple, speedy and inexpensive
settlement of consumer complaints.
• Salient features:
1. Covers all goods and services
2. Applicable to all sector
3. The Act is in addition to and not in derogation of the provision
of any other law for the time being in force.

8. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Basis District State Commission National
Commission
Composition It consists of a
president and two
other members.
It consists of a
president and two
other members.
It consists of a
president and four
other members.
Jurisdiction Value of service and
compensation
claimed shall not
exceed Rs. 20 lakhs.
Value of service and
compensation claimed
shall be more than Rs.
20 lakhs but shall not
exceed Rs. 1 crores.
Value of service
and compensation
claimed shall be
more than Rs. 1
crores.

9. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Basis District State Commission National Commission
Appeal
against
orders
Any person who is
aggrieved by the order of
District Forum can appeal
against such order to
State Commission within
30 days and by depositing
Rs 25000 or 50% of the
penalty amount
whichever is less.
Any person who is
aggrieved by the
order of State
Commission can
appeal against such
order to National
Commission within
30 days and by
depositing Rs 35000
or 50% of penalty
amount whichever
is less.
Any person who is
aggrieved by the order
of the National
Commission can appeal
against such order to
Supreme Court within 30
days and by depositing
50% of penalty amount
but only cases where
value of goods or
services exceeds Rs 1
crore can file appeal in
Supreme Court.

10. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
• Ombudsman means an investigating officer relating to
the grievances of general public against administration
actions.
• The objective of Insurance Ombudsman is to efficiently
and in impartial manner resolve the complaints relating
to the settlement of claim under general insurance and
life insurance policies.
• Insurance Ombudsman is appointed by the Governing
Body of Insurance Council, a body consisting of
representatives of each insurance company.

11. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Insurance Ombudsman
• Subject Matter of Complaint:
 Any partial & total repudiation of claim.
 Any dispute in regard to premium paid.
 Any dispute on legal construction of the policy.
 Delay in claim settlement
 Non issuance of policy after receipt of premium.
Manner of lodging complaint:
1. Complaint is to be filed in writing containing the details such
as name & address of complainant, name & address of
insurer, reason of complaint, loss occurred etc.

12. TRINITY INSTITUTE OF PROFESSIONAL STUDIES
Sector – 9, Dwarka Institutional Area, New Delhi-75
Insurance Ombudsman
2. The parties have to appear in person before the
ombudsman on the decided date and no advocate is
allowed.
3. Through mediation (mutual understanding) ombudsman
attempt to dispose off the complaint and make
recommendation which he thinks is fair.
4. The complainant has the option to accept or reject the
recommendation. If accepted, the insurer has to comply
with them within 15 days.
Ombudsman shall pass award within 3 months from receipt
of complaint.