Insurers are legally bound by an ombudsman’s award

Insurers are legally bound by an ombudsman’s award
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First Published: Fri, Aug 01 2008. 04 04 PM IST

Updated: Fri, Aug 01 2008. 04 04 PM IST
This refers to your response to a query on the insurance ombudsman. Within how much time should one file a case with a consumer court after receiving intimation from an insurer or ombudsman? What if there is a delay?
Any case that needs to be filed before the Consumer Forum shall have to be done so within two years from the date of repudiation of the claim or date of receipt of intimation as per the Act of Limitation. Any delay can be condoned, at the discretion of the consumer court, if valid or justifiable reasons are cited.
How does a policyholder seek redress in case he is a resident of say, Pune, where there is no ombudsman? Will he be required to come to Mumbai? Also, can the insurer challenge the ombudsman’s award?
The policyholder can seek redress with the ombudsman by correspondence itself. His physical presence is not required, except at the time of enquiry wherein he might be called to present his case.
The order of the ombudsman is not binding upon the insured, unless he accepts it in writing. In case he feels that he has been aggrieved, he can file a civil suit in the courts or take up his case with the consumer forum. Insurance companies are legally bound to comply with the orders of an ombudsman since they have at the outset given their concurrence in writing to comply with all their directives.
Ajay Bimbhet is managing director, Royal Sundaram Alliance Insurance Company Ltd.
Readers are welcome to write in with their life and general insurance queries to insurancequeries@livemint.com. The questions will be answered by senior executives from leading insurance firms.
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First Published: Fri, Aug 01 2008. 04 04 PM IST