HANDLING CUSTOMER COMPLAINTS IN

INSURANCE: ISSUE OF MAJOR CONCERN

INTRODUCTION

• Customer complaints are frequently a business owner’s worst nightmare. Faced with an aggrieved
customer many small business managers simply shut down, either avoiding the customer’s
communication or giving unhelpful or unsympathetic responses.
• Complaints are a great source of valuable information about business and customer base.
• In India, because of poverty, insurance is more of a luxury than necessity.
REASONS WHY CUSTOMERS
COMPLAIN
• 1. Not Keeping Promises
• 2. Poor Customer Service
• 3. Transferring From One CSR to Another
• 4. Rude Staff
• 5. No Omni-channel Customer Service
• 6. Not Listening to Customers
• 7. Hidden Information and Costs
• 8. Low Quality of Products or Services
• 9. Keeping an Issue Unresolved
COMPLAINTS HANDLING POLICY

• Insurance companies should develop a complaints handling policy. It should include reassuring
customers that company values their feedback and they are committed to resolving their issues in a fair,
timely and efficient manner.
COMPLAINTS HANDLING PROCEDURE

• Once an insurance company have developed a policy it can create a procedure for handling complaints.
A procedure will ensure complaints are dealt with the same way, every time. The procedure should be
easy to understand and follow by all the staff.
WHY TO RETAIN INSURANCE
CUSTOMERS?

• Companies are moving from product centric approach to customer centric approach. It is not important
“what” you sell, what is important is “who” you are selling it to.
• Customer retention is “an assessment of the product or service quality provided by a business that
measures how loyal its customers are.
• Customer delight is defined as “the very favourable experience of the client of a business when they
have received a good or service that significantly surpasses what they had initially anticipated.
• Customer retention leads to increased benefits for insurance company.
MEASURES FOR CUSTOMER
RETENTION

• Customer retention does help in cost reduction but timely and proper analysis of existing customers is
important. Insurance companies must invest on the existing churned customers for bringing in more
and more revenues and new prospects for the company. Such customers must be rewarded or
honoured time to time to keep them glued with the insurance company forever.
• Insurance company must make its presence felt to the existing loyal customers everywhere and
anywhere.
•  Motivation of employees and customers play a vital role in insurance industry
IRDAI
• IRDAI has through various regulations mandated the following requirements to be complied with by all
insurers-
• Ensure a board approved grievance redressal policy document is in place
• All complaints must be logged in through integrated grievance redressal portal of the authority
• Every insurer must have grievance redressal officer (GRO) whose contact details are provided in all the
communication with the policy holder
• Insurer must abide by the grievance redressal guidelines advised by IRDAI
• Regular reporting of all category of complaints & reconciliation of pending complaints is order of the
day
INSURANCE OMBUDSMEN
• With an objective to provide a forum for resolving disputes and complaints from the aggrieved insured public or
their legal heirs against Insurance Companies, the Government of India, in exercise of powers conferred on it u/s
114(1) of Insurance Act, 1938 framed "Redressal of Public Grievances Rules, 1998", which came into force w.e.f.
11th November, 1998.
• To implement the above Rules, the Institution of Insurance Ombudsman has been established and is functioning
since 1999.
• Complaint to the Ombudsman can be about:
• Delay in settlement of claims, beyond the time specified in the regulations, framed under the IRDAI Act, 1999.
• Any partial or total repudiation of claims by the Life insurer, General insurer or the Health insurer.
• Any dispute about premium paid or payable in terms of insurance policy
• Misrepresentation of policy terms and conditions at any time in the policy document or policy contract.
THANK YOU