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Old 17th August 2010, 15:24   #16
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My car's comprehensive insurance got lapsed on (11th of May) which was with ICICI Lombard.

Reading the horror stories about ICICI, I went to Bajaj Allianz. The surveyor came and surveyed my car. I did the payment on phone though my credit card when the Insurance person promissed me I will get the insurance receipt in 48 hours. I waited for 4 days and I still did not receive my insurance docs, not a receipt of the payment made.

I tried calling back the insurance guy whom I was in contact with for the insurance, but he never received my calls. If I called from different numbers he hung up as soon as he came to know it's me. I later wrote a mail to few people I know in Bangalore Bajaj branch.

They said the insurance policy which I approached was handled by the head office, Pune branch so they could not do anything. I later called the CFU in Pune branch and told him I don't want the policy any more as their service was even worse than ICICI and I need refund of my money. He confirmed I will get back the refund in 7 days.

It has been more than 3 weeks now, and I did not receive my refund. On writing mails, I just get responses like :-

Dear Sir,
Sorry for delay in reply, we have already processed this refund and have also sent a written to our Accounts team on the same , will ensure that we get back to you with the updated status latest by 4pm today
Mentioned below is the request number of your refund for your ready reference
Request Number:-

Also let me know how to proceed. I am least interested in the money refund. I just want to teach these guys a lesson. Specially the person who hung up on me and did not receive my calls.[/FONT][/COLOR]

Last edited by Googleman : 17th August 2010 at 15:26.
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Old 11th July 2015, 12:37   #17
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Default Re: Frequently Asked Questions (FAQs) On Insurance Ombudsman And Its Working:

Originally Posted by rjvora_2000 View Post
Working of ombudsman is very simple, please read this FAQ and you will come to know the same.

Thank you.
In case of partial admission of a motor claim, can one approach Ombudsman and demand money for mental agony too (in addition to the disputed amount??)
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Old 26th April 2016, 16:21   #18
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Default Re: Frequently Asked Questions (FAQs) On Insurance Ombudsman And Its Working:

Jim Peter Saju shared the following story on our Facebook page:

Posted on April 14, 2016 by peterjim13

Have you ever tried fighting some corporate for their wrong doing or their lack of respect to you as a customer. I have tried once, it may take some time though. And I would proudly say “I won !” and yes I am that bloody customer.

My short note on the same.

Why ? I had some real fight with HDFC Ergo General Insurance for their irresponsible and unprofessional staff and for the hardships they have put me in being a customer. After an accident involving my car and a two-wheeler, my car was put for repairs at the Garage (Kairali Ford, Cochin) for about 43 days to get some not so major work done. Simply because of the insurance providers lack of competence.

After getting everything done to legally locate myself in a position to get the claim without hassles, I had to wait for the mercy of the Surveyor (Arun Kumar, Claims Manager, MG Road Office) who just slept over my claim, bargained for clearing only a part of it. He offered 50% and then 60%, and this went on for a week or more.

That’s when I decided, wait no.. !! These are a few things we are legally bound to win, so decided not to bend myself to these fiasco and to battle it out.

I decided to fight ! With the confidence I gained from a very senior Employee with a Nationalized insurance company, I told the insurance guy that “My car will come out of the garage only through the payment of the works legally covered under insurance paid by your company. I am going to wait, and not gonna help with any other stuff to make your life easier“. This conversation went on for about 3 weeks, I emailed every available email id owned by HDFC Ergo and they too sang the same song like the claims manager.

Relief mid way. At about 20 days post the incident, he called me up and said – that the insurance claim has been awarded and they shall commence the work at the Garage. I thanked him for his understanding and produced all necessary documents for speeding up the claim process at his office. Later at about a week, he again gives me a shocker that the General Diary Entry Issued by the Traffic Police on the incident has a small correction and he is going to reject the claim. This is a document which I handed over on the first day and now he is complaining on the same about a month later. Without delay I go the corrected documents from the police station and then reproduced all the documents with the correction made. This dragged the whole thing to about 30 days and later the Senior Claims Manager intervened to put things move faster and asked me to get the work done and assured me about a reimbursement option within 3 days.

Post the body work. Again to my shock on the 43rd day since the incident, my car comes out of the Garage with about Rs. 4,500 of the total rs. 70,000 declined by the insurance company. This is when I started getting my appeal to the Insurance Ombudsman prepared; collating all the documents, printed copies of emails, extracts from the conversations, proofs etc. I got my car and had to put around 10K from my pocket including the ones which are not covered under insurance.

The Solution :

If you ever had to face such a situation, you always have an option to reach out to The Insurance Ombudsman, who has offices in every state in India. My detailed complaint covered about 64 Pages and got it couriered to the Insurance Ombudsman.

On the 10th day, I get an acknowledgement from the Ombudsman office on the acceptance of my case, and a request response for a consent to proceed with a hearing of the same case. At about 15 days later I get another letter inviting me for the hearing of the case at Calicut (since that was the closest place to my permanent address) and on Feb 17th; I had the hearing at Calicut which got over in about 15 minutes.

The representative of the HDFC Ergo Insurance Company had no claims to make against and agreed to settle the rest of Rs. 4500 which were rejected without any hearing. Still I was given a chance to make the plead and I had also requested for a compensation amounting to Rs. 15000 for the hardships, loss of pay days, and also the cost of travel while I was car less. Ombudsman told me that, there is no room for compensation under this scenario and assured me of justice without delay. But he also suggested me to reach out to IRDA to file a case against the Surveyor who was in turn the claims manager – to produce his certificate (B grade) to ensure whether he was a genuine Insurance Surveyor holding the Certificate. (Which in turn would be my second battle in the line up) The AWARD letter which came in the month of March also had an additional Rs 500 as the travel cost incurred by me, for the hearing (i suppose).

I was given the cheque of the same amount from the Insurance Company on April 4th of 2016, and when I look back at the incident which occurred way back in October 2015.

I am sure that many may see this as some battle which may not be worth it. Especially for those who could afford this 5,000 or may be the whole 70,000.

I am sure that, this may not be something big for the company itself, probably there would be some 1 or 2 of every 20 claims that are taken to the Ombudsman, but as a customer we need not run into court for everything. And need not put down the fight thinking that Court is the only hope. There are parallel bodies like these who help in the same. And it’s not about whether there are ways we could get such things sorted? it’s all about whether we want to make the fight or not!

Always be the empowered customer and not just customer, let the money that our parents spent on our education pay off.

Note : Now I have renewed my Motor Insurance with HDFC Ergo itself, because they would obviously know that – “I know” how they work.
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Old 26th April 2016, 16:41   #19
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Default Re: Frequently Asked Questions (FAQs) On Insurance Ombudsman And Its Working:

Originally Posted by GTO View Post
What if their ruling is in favour of the complainant, and the insuring company is (obviously) not happy with it. Does the insurer have to comply with the ruling, or...?
The Ombudsman's decision is binding on the insurance provider (no appeals allowed at higher courts), but the complainant has the right to appeal. See below link for details

The ombudsman shall pass an award within a period of three months from the receipt of the complaint. The awards are binding upon the insurance companies.

If the policy holder is not satisfied with the award of the Ombudsman he can approach other venues like Consumer Forums and Courts of law for redressal of his grievances.

Last edited by jinojohnt : 26th April 2016 at 16:43.
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