Submit documents promptly to Ombudsmen or face ex-parte orders, IRDAI tells insurers

The Insurance Regulatory and Development Authority of India (IRDAI) has set timelines for insurers to submit documents related to complaints before the Insurance Ombudsmen and warned that non-compliance could result in ex-parte orders.

The regulator has directed all the insurers, except reinsurers, to submit the self-contained note (SCN), along with all supporting documents, within seven days of receiving a notice from Insurance Ombudsmen concerned. Any additional information or documents sought by Ombudsmen must be furnished within three days of the notice.

All the required information and relevant documents should be submitted in “one-go” rather than in a piece-meal manner, IRDAI said in a circular.

Clear pending demands within 30 days

It also directed insurers to clear all pending requests for SCNs, additional information and supporting documents from the offices of Ombudsman within 30 days of the circular.

Failure to comply will result in Insurance Ombudsman concerned proceeding with the matter ex parte, based on the information available on record, without further delay, the regulator said. In support, it cited Rule 17(4) of the Insurance Ombudsman Rules that require Ombudsmen to finalise findings and pass awards within three months of receiving all required information from the complainant.

Inordinate delays

Executive Director R.K.Sharma, in the circular, said IRDAI had noted with concern the inordinate delays by insurers in submitting SCNs, supporting documents and additional information sought by Ombudsmen. Besides raising this, the Insurance Ombudsmen, during a recent orientation programme, had also pointed out that insurers often submit documents in a piecemeal fashion and after significant delays. Such an approach in turn to lead to delay in disposal of the complaints filed by policyholders/beneficiaries.

During 2025-26, the Insurance Ombudsmen had decided 41,055 grievances. Of these 79% were in favour of the policyholders, IRDAI had said during an orientation programme it organised in May.