Insurance Ombudsman Complaint 2026

Reviewed on: 2026-06-19.

The Insurance Ombudsman is open to individual policyholders and their legal heirs, nominees, or assignees. Sole proprietors and micro enterprises also qualify. Partnerships, companies, and other corporate entities cannot use this forum.

You may file against:

• Your insurance company (life, health, or general)
• Your insurance broker

Before the Ombudsman will register your complaint, three conditions must be satisfied:

1. You wrote to your insurer first. A formal written grievance to the insurance company or broker is mandatory. Verbal complaints do not count.
2. Thirty days have passed without resolution. Either the insurer did not reply within one month of your written complaint, or you are not satisfied with the reply you received.
3. You file within one year. Your complaint to the Ombudsman must reach the office within one year from either: (a) the date the insurer rejected your representation, or (b) the date the one-month response window expired without a reply.

If these three conditions are met, the Ombudsman will hear your case at no cost to you.

The Insurance Ombudsman Rules 2017 (as amended till 09.11.2023) cover a wide range of disputes:

• Delay in settlement of a claim
• Partial or full rejection of a claim
• Disputes over the premium charged or refunded
• Policy mis-selling or misrepresentation at the time of sale
• Non-issuance of a policy document after premium payment
• Coverage disputes and policy interpretation
• Servicing complaints against insurers or brokers

The single ceiling: the compensation you seek must not exceed Rs 50 lakh (including any relevant expenses). Claims above this threshold cannot be taken to the Ombudsman and should be pursued through a consumer forum or civil court instead. See how to file on eDaakhil for that route.

The Council for Insurance Ombudsmen operates an online portal at cioins.co.in/Complaint/Online.

1. Verify your mobile. Enter your mobile number and confirm the OTP (valid for 90 seconds).
2. Select the respondent. Choose whether your complaint is against an insurance company or a broker.
3. Enter complainant details. Provide your name, gender, date of birth, state, city, address, and pin code.
4. Confirm jurisdiction. The Ombudsman with jurisdiction is usually the one covering your residential address or the branch where the policy was issued.
5. Enter complaint details. Provide the policy number, date of the incident or grievance, and a clear description of the problem.
6. Confirm prior representation. Tick that you already wrote to the insurer first.
7. Upload documents. Each file must be PDF or JPG, not larger than 10 MB.
8. Submit. You will receive an acknowledgement reference number. Track your complaint at cioins.co.in/Complaint/Track.

If you prefer not to use the online portal, you can:

• Email the relevant Ombudsman office directly
• Send a complaint by post to the office covering your jurisdiction
• Walk in to any of the 18 Ombudsman offices across India

The 18 office cities are: Ahmedabad, Bengaluru, Bhopal, Bhubaneswar, Chandigarh, Chennai, Delhi, Guwahati, Hyderabad, Jaipur, Kochi, Kolkata, Lucknow, Mumbai, Noida, Patna, Pune, and Thane.

City addresses and contact details are listed at cioins.co.in/Ombudsman.

Once the Ombudsman accepts your complaint:

1. The Ombudsman first attempts mediation between you and the insurer to reach a settlement both parties agree to.
2. If mediation fails, the Ombudsman passes a formal Award (decision).
3. The Award is binding on the insurer. The insurer must comply within 30 days of receiving the Award.
4. You are not bound. If you are unhappy with the Award, you may still approach a consumer forum, civil court, or use any other legal remedy available to you.

No fees are charged at any stage. The Council for Insurance Ombudsmen does not charge policyholders for grievance redressal.

Before filing with the Ombudsman, many policyholders first register their grievance on IRDAI's Integrated Grievance Management System (IGMS) at igms.irdai.gov.in (also accessible via the Bima Bharosa portal at policyholder.gov.in). IGMS routes your complaint directly to the insurer's grievance team and gives IRDAI visibility.

Filing on IGMS is not a legal prerequisite for the Ombudsman, but it creates a timestamped record of your complaint to the insurer, which helps establish that you met the 30-day wait requirement. If the insurer does not resolve your IGMS complaint within 30 days, you have a documented basis to approach the Ombudsman.

If your complaint concerns a government health scheme, check Ayushman Bharat claim status first, as those grievances follow a separate track under NHA. For complaints against your bank's insurance tie-ups, the Banking Ombudsman may also be relevant.

Yes. The Insurance Ombudsman Rules 2017 apply to all insurance companies operating in India, whether public sector (such as LIC, New India Assurance) or private. The insurer's ownership does not affect eligibility.

No, not for the full amount. The Ombudsman can only award up to Rs 50 lakh. If your claim exceeds this ceiling, you must approach a consumer forum or civil court. You could also accept a partial Rs 50 lakh Award and seek the balance through another forum, but consult a legal professional before splitting claims.

Yes. A partial settlement that you have not accepted in full satisfaction is still a live grievance. Write to the insurer rejecting the partial settlement, wait for their response or 30 days, then file with the Ombudsman.

The Award is binding on the insurer, not on you. If you reject the Award, you retain the right to approach the consumer commission under the Consumer Protection Act 2019, or file a civil suit. See consumer complaint on eDaakhil for the forum route. You cannot simultaneously pursue both the Ombudsman and a court for the same grievance.

The Council for Insurance Ombudsmen can be reached at: 022-69038800 / 022-69038812 (Council office, Mumbai). For IRDAI general grievance enquiries, contact the IRDAI Bima Bharosa helpline via policyholder.gov.in.

Yes, provided the policy was issued in India. The jurisdiction is typically determined by the branch where the policy was issued or the address of the proposer at the time of purchase. Contact the relevant Ombudsman office to confirm jurisdiction before filing.

The Rules require the Ombudsman to endeavour to settle complaints within three months of receipt. This is a target, not an enforceable deadline, but most offices aim to meet it. Keep a copy of your acknowledgement reference number to follow up if the timeline extends.

File an RTI to: IRDAI (Insurance Regulatory and Development Authority of India), a public authority under the RTI Act 2005

Useful questions to ask:

• What is the total number of Insurance Ombudsman complaints received and disposed in the last three years, office-wise?
• How many complaints were decided in favour of the complainant, and what was the aggregate award amount?
• What is the average time taken by each Ombudsman office to settle complaints?
• Has IRDAI issued any directions to a specific insurer for non-compliance with Ombudsman awards?
• What is the procedure for amending the Insurance Ombudsman Rules, and are any amendments under consideration?

For a parallel channel, CPGRAMS accepts grievances against central government-regulated bodies including IRDAI.

→ Use our free AI RTI Drafter to generate a complete Section 6(1) application.

• Council for Insurance Ombudsmen (CIO) - www.cioins.co.in
• CIO Online Complaint Portal - cioins.co.in/Complaint/Online
• CIO Ombudsman Offices List - cioins.co.in/Ombudsman
• Insurance Ombudsman Rules 2017 (as amended till 09.11.2023) - cioins.co.in/OmbudsmanRules2017
• IRDAI - irdai.gov.in
• IRDAI IGMS / Bima Bharosa - igms.irdai.gov.in
• IRDAI Policyholder Portal - www.policyholder.gov.in

By Dr. Shrawan Kumar Pathak