Page 21 - The Insurance Times October 2025
P. 21

Tesco responsible, reaffirming businesses have a duty of care  policyholders encounter-like repudiation of claims, delays,
          towards the public and insurers must settle claims when  and gaps in documentation.
          such duty is violated. The case highlights the expectation
          that insurers must act promptly and not procrastinate with  Table 2: Frequent categories of complaints
          rightful settlements.
                                                              in public liability insurance (on the basis of
          Since the global liability insurance market is expected to 100 Ombudsman-disputed cases).
          reach $432.81 billion in 2032, at a growth rate of 5.4%, the  Category of Complaint  Number of  Percentage
          requirement for grievance redressal processes that are
                                                                                       Complaints   of Total
          efficient and transparent is even more essential. In the
          absence of timely settlement of claims and transparency of  Repudiation of Claim  59      59%
          communication, the intent of liability insurance-financial  (Partial/Total)
          relief and legal representation-is undermined. Therefore,  Delay in Claim Settlement 17   17%
          grievance redressal is not just an operational process but a  Dispute Over Premiums  8    8%
          core pillar of trust in the insurance industry.      Dispute Regarding       7            7%
                                                               Policy Terms
          The Common Categories of Complaints                  Non-Issuance of         9            9%
          in Public Liability Insurance                        Documents

          Realizing the nature and number of complaints under public  Total            100          100%
          liability insurance is imperative to assessing the efficiency
          of grievance redressal mechanisms. This section displays two  Collectively, these data present an overall picture of both
          major  data tables-one  indicating  year-wise  trends  in  the extent and character of complaints in this insurance
          complaint numbers and disposal, and the other illustrating  market, with significant insights into repeat issues and
          the most frequent categories of grievances complained of  scopes for service enhancement.
          by policyholders.
                                                              Performance of Insurance Ombudsman
          The  initial table  illustrates  the  volume  of complaints  (India): FY 2022-23 & 2023-24
          received and settled by the Insurance Ombudsman over
          chosen financial years between 2008 and 2024. It shows the  During the previous two fiscal years, India's Insurance
          way complaint numbers have evolved over time and how  Ombudsman scheme has seen a dramatic shift in grievance
          effectively the redressal system has managed them.  redressal processes-characterized by increased disposal
                                                              rates, digitalization, and a greater emphasis on mediation.

          Table 1: Year-wise summary of complaints            These trends have improved the efficiency and convenience
                                                              of  complaint  settlement,  enabling  quicker  and  more
          received and disposed of by the Insurance           transparent services to policyholders.
          Ombudsman (2008-2024)

           Year       Complaints   Complaints    Disposal
                       Received     Disposed     Rate (%)
           2008-09      26,177       27,790         ---
           2016-17      27,627       27,790         100
           2017-18      25,478       17,225        67.6

           2022-23      51,103         ---          ---
           2023-24      52,575       49,705        94.5

          Source: Council of Insurance Ombudsman

          Subsequent to this, the second table displays a complaint-
          wise breakup of grievances, drawn from a sample of 100
          cases. It aids in determining the most common issues

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