The insurer hasn't complied with the Ombudsman award — what can I do?

An insurer must comply with an Ombudsman award within 30 days of receiving it and tell the Ombudsman it has done so. If it does not, IRDAI's master circular makes a penalty of ₹5,000 for each day of delay payable to you, on top of penal interest, unless the insurer chooses to appeal within 30 days, in which case it must inform you. Check the dates first, then write to the insurer and to the Ombudsman's office; you can also complain to IRDAI.

Rule 17 of the Insurance Ombudsman Rules makes an award binding on the insurer, requires it to comply within 30 days of receiving the award, to tell the Ombudsman it has complied, and to upload the details to the Council's complaints management system.^[1]

First, check the dates

• When the insurer received the award: The 30 days run from the insurer's receipt of the award, which may be a little after the award's own date. A copy of the award is sent to both you and the insurer.^[1]
• Whether you were told of an appeal: IRDAI's circular says the penalty does not apply if the insurer chooses to appeal within 30 days, and that you must then be informed. Check your post and email.^[2]
• What the portal shows: The Council's tracking page carries the award stage, and the Rules require the insurer to upload its compliance details to the complaints system.^{[3, 1]}

What applies when an award is not honoured

The 'bank rate' is defined in IRDAI's 2024 Regulations as the Reserve Bank of India's bank rate on the first day of the financial year in which the claim fell due. This page does not work out an interest figure; take the rate for your year from the RBI.^[4]

Steps you can take

1. 1

   Write to the insurer

   Address its grievance officer. Quote the award's number and date and the date the insurer received it, refer to rule 17(6), and ask for payment with the interest the Rules provide and the penalty in IRDAI's circular. Keep proof of sending.^{[1, 2]}

2. 2

   Tell the Ombudsman's office

   The Rules require the insurer to report its compliance to the Ombudsman, so the office that passed the award is the natural place to report that you have not been paid. Quote your complaint number. The Rules do not describe what the office does next.^[1]

3. 3

   Complain to IRDAI

   You can register a complaint on Bima Bharosa, and ask for IRDAI's review if the insurer's response does not resolve it. IRDAI describes that review as a check for possible violation of regulations; it is the circular that sets the penalty.^{[2, 5]}

4. 4

   Keep a record

   Every letter, every date and every reference number in one place. If the matter goes further, that record is what you will rely on.

5. 5

   Know where advice is needed

   Enforcing an award through the courts is a legal question this page does not answer; take independent legal advice if the steps above do not resolve it.

ClaimAssure is an independent private platform. It is not an insurer, IRDAI, Bima Bharosa or the Insurance Ombudsman, it never files anything on your behalf, and it cannot promise any outcome. What it does is read your documents and show you what they say.

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