Bima Lokpal Explained: Simplifying Insurance Complaints for Policyholders.

When it comes to insurance and policies everyone of us just knows the tip of the iceberg. Even after repeated reminders, we don’t read all the terms and conditions and even if we go through them, we don’t understand even half of it. 

This is where our institution Claims Nidan comes in the picture. We are here to make you understand the Bima Lokpal, also known as Insurance Ombudsman and also to guide you through the process of filing complaints. Further in the article we will explain how it works and why it is important for policyholders. 

What is Bima Lokpal?

If we try to break it down in simple words, Bima Lokpal basically means appointing an official person who can help you with resolving any dispute one has with an insurance company. Being a policyholder, you should be aware of all the points mentioned in your policy and how to benefit from it in your crucial times. 

The Bima Lokpal functions under the aegis of the Insurance Regulatory and Development Authority of India (IRDAI) and is governed by the Insurance Ombudsman Rules, 2017. This concept was introduced in-favor of policyholders, so that they can get solutions to their problems in no time. One can refer to it as a less formal way to resolve disputes between policyholders and insurance companies.

Understanding the Scope of the Bima Lokpal’s Jurisdiction

The Bima Lokpal has jurisdiction over various types of insurance-related grievances, including:

Policy Issuance and Premiums: here we cover all the issues related to issuance of policy, terms and conditions mentioned in the policy and issues related to premium amounts.

Claims Settlement: if there is any delay, denial or any sort of partial payments that havent been updated till date,all these  come under the section of claims settlement. 

Policy Service Issues: if there is any sort of delay or grievances from the insurance company’s side, regarding policy renewal, changes in terms and condition or non-receipt of documents, policyholders can file a complaint under this title.

Misrepresentation and Non-disclosure: at any given point, if the policyholders feel that they don’t have all the important information or they have been misled, they can raise a complaint.

Refunds and Cancellations:  this handles any non-payments of refunds or delaying the process even after policy cancellation.

How to File a Complaint with Bima Lokpal

Here’s a step-by-step guide on how to file a complaint with Bima Lokpal:

1. Attempt Resolution with the Insurer: the first step should always be approaching the company and trying to resolve the issue through filing a complaint with the customer service department. If one doesn’t get the response or required solution then the policyholder can go for Bima Lokpal.

1. Wait for a Response: insurance companies usually get a slot of 30 days to resolve the issue of policyholder, if they fail to do so, one can move forward with Bima Lokpal.

1. Lodge the Complaint with Bima Lokpal: if the policyholder doesn’t get satisfactory response from the insurance company, their next step should be filing a complaint with Bima Lokpal. The complaint must be filed within one year from the date of the insurer’s final response or the end of the 30-day waiting period.

1. Submit Required Documents: to file the complaint with Bima Lokpal, policyholders should submit all the relevant documents with a written application. Documents like copies of the policy and any other correspondence with the insurer.

1. Hearing and Resolution: if required Bima Lokpal may hold a hearing, where both policyholder and insurance company will be allowed to keep their sides and based on the presented information, Bima Lokpal will give a solution or award to resolve the complaint.

1. Implementation of Award: if the policyholder is satisfied and is ready to accept the award as the solution then the insurance company has to implement it within 30 days of the time period, whereas if the policyholder isn’t satisfied with the solution then they can proceed with the case in court of law.

Benefits of Using Bima Lokpal

Bima Lokpal is designed for policyholders, so that they can resolve their issues with the insurance companies and have knowledge of their power, some of the benefits of Bima Lokpal are listed below:

1. Cost-Effective: The most important point to be noted about Bima lokpal is that you don’t have to pay any additional cost to file a complaint. That is what makes it accessible to the masses.

1. Speedy Resolution: we can call it an informal way to resolve issues but it guarantees that the issue is resolved in less time as compared to the traditional legal proceedings.

1. Impartial and Fair:  Bima Lokpal is an independent authority, it isn’t biased and as result of it, all the issues are evaluated fairly.

1. Simplified Process: Bima Lokpal is a very straightforward and simple process. It doesn’t have any complicated procedures like the legal hearings. Policyholders can easily understand it and file a complaint

1. Accessible Across India: it is very easy to reach out for Bima Lokpal, as it has multiple offices across India. One can find the nearest office in their region easily and get all the assistance regarding their problem.

Limitations of Bima Lokpal

Bima Lokpal has several benefits, but it comes with certain limitations too:

1. Monetary Limits: as of now, Bima Lokpal can only resolve issues that have a claim amount of INR 30 lakhs or less. Claims of higher monetary value need to be resolved through legal proceedings.

1. Specific Jurisdiction: Bima Lokpal Jurisdiction is limited to handling claims that are personal. Corporate or group insurance is not covered under Bima Lokpal.

1. Non-Binding Recommendations: Recommendations of the Bima Lokpal are generally accepted by insurance companies but they are not legally binding. Insurance companies can even refuse to consider them and as a result policyholders will have to go through the legal procedure to get their claim.

Conclusion: Empowering Policyholders through Bima Lokpal

As to conclude, Bima Lokpal is a powerful tool for policyholders. Insurance ombudsman not only makes it easier for the policyholders, it also ensures that they get their claims in no time. Going against powerful insurance companies can be very intimidating at times but Bima Lokpal makes it very convenient for the policyholders. 

Bima Lokpal is cost effective and less time consuming as compared to legal proceedings. It not only ensures impartial solutions but it has simplified the process for policyholders and has multiple offices across India for policyholders to approach them.

Understanding Bima Lokpal is important, it comes with several benefits but it has limitations associated with ir as well. Bima Lokpal deals with Personal Insurance policy related disputes only. Corporate and group policies are not  covered under this as of now. It has a claim amount limitation as well. Any claim that has a value larger than 30 lakhs involved, cannot be resolved with Bima Lokpal. 

Nonetheless, policyholders have an upperhand with the Bima Lokpal in existence. Policyholders can keep their problems and get fair advice and solutions to their disputes they are facing with insurance companies. Providing policyholders with the knowledge and power is the core reason that Bima Lokpal was designed, policyholders can get what they rightfully deserve with Bima Lokpal.