There are some reports that some hospitals are not granting cashless facility for treatment of Covid-19 despite policyholders being entitled for getting cashless treatment under their Policy.
Thus, in the event of denial of the cashless facility at any such enlisted network providers hospitals, the policyholders may send a complaint to the concerned insurance company.
Further, you can also approach to Insurance Ombudsman or the Grievance Redressal Officer. The Grievance Redressal Cell in the Consumer Affairs Department of the Insurance Regulatory and Development Authority of India (Irdai) looks into complaints/grievances from policyholders. This Cell takes up the grievances with the respective insurers for redressal.
How to file a complaint
Policyholders who have complaints against insurers need to first approach the Complaints/Grievance Redressal Cell of the insurer concerned. If they do not receive a response from the insurer within a reasonable period which is usually 15 day of the complaint receipt or are dissatisfied with the response of the company, they may approach the Grievance Redressal Cell in the Consumer Affairs Department of the Irdai.
You must know that only complaints from the insured or the claimants are entertained. The Cell doesn’t entertain complaints written on behalf of policyholders by advocates or agents or by any third parties.
The complainants need to submit the complete details of the complaint as required in the complaint registration form which they can download from the Irdai website – policyholder.gov.in (http://www.policyholder.gov.in/Report.aspx#). Without the required information called for in the complaint registration form, Irdai will not register the complaint.
How to register complaints with the Irdai
You can make use of the Integrated Grievance Management System(IGMS). It is an Irdai Portal at https://igms.irda.gov.in for registering the complaints and monitoring the status of the complaints.
Secondly, you can send the complaint through Email to [email protected] Third, you can call Toll Free No. 155255 or 1800 4254 732. Besides, if you feel necessary to send the communication in physical form, the same can be sent to Irdai official addressed to: General Manager, Insurance Regulatory and Development Authority of India(IRDAI), Consumer Affairs Department – Grievance Redressal Cell, Sy.No.115/1, Financial District, Nanakramguda, Gachibowli, Hyderabad – 500 032.