Insurance ombudsman

Querist : Anonymous (Querist) 18 August 2011 This query is : Resolved
What is status of Proceedings before Insurance Ombudsman , whether Office of Insurance Ombudsman enjoys court status ?

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ajay sethi (Expert) 18 August 2011
no formal court procedures are involved .
any recommendation or award made by ombudsman are subject to acceptance by both complainant and respeondent . if dis-satisfied can proceed legally against insurance compnay in court of law.

Dr Anil Kumar Singh (Expert) 18 August 2011
I agree with expert : Ajay Sethi

Querist : Anonymous (Querist) 18 August 2011
What is significance of Time Limit prescribed under RPG Rule 1998 for Recommendation by Insurance Ombudsman “ as not later than one month “ or “ Award within Three month period from receipts of complaint ” is mandatory or indicative or suggestive in nature or just idealistic hence informative in nature ? what remedy is available under RPG Rule against Insurance ombudsman not giving Recommendation or Award within time limit of RPG Rules.

prabhakar singh (Expert) 18 August 2011
(3) No complaint to the Ombudsman shall lie rule 13(3)reproduced below is Mandatory

unless:-

(a) the complainants had before making a complaint to the Ombudsman made a written representation to the insurer named in the complaint and either insurer had rejected the complaint or the complainant had not received any reply within a period of one month after the insurer concerned received his representation or the complainant is not satisfied with the reply given to him by the insurer.

And the rule 16(3) reproduced below is directive in its nature:

Rule16(3) The Ombudsman shall pass an award within a period of three months from the receipt of the complaint.

Raj Kumar Makkad (Expert) 18 August 2011
I do agree with prabahakar singh

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