What If Something Goes Wrong?
If someone purchases an insurance policy and at the time of the occurrence of the claim, the insurance company says that it is not liable to pay for the losses for reasons such as:
- the peril was not covered;
- the policy had exclusions;
- they have a limit to pay, etc.
- or it takes longer than usual to process the claim;
Then the policyholder has certain readily available recourse mechanisms. Some of the steps are mentioned below:
- The policyholder can write to the insurance company regarding his/her grievance while mentioning the intention to file a complaint with the office of the insurance ombudsman;
- If the insurance company does not give satisfactory reply within one month, the policyholder can an application with the office of the Insurance Ombudsman within three months. The Insurance Ombudsman is an autonomous national dispute resolution body which is expected to independently and impartially resolve insurance disputes, between insurance policyholders and participating companies, without charging ant fees;
- A complaint is required to be made on solemn affirmation or oath in writing addressed to the Insurance Ombudsman. The complaint shall set out the full particulars of the complaint matter and the name and address of the complainant.
To access the office of the Insurance Ombudsman contact the address below:
Federal Insurance Ombudsman’s Secretariat
2nd Floor, Pakistan Red Crescent Society Annexe Building
Plot # 197/5, Dr Daud Pota Road
Tel: +92 21 992 077 61 (62 and 63)
Fax: +92 21 992 077 63
For guidance on matters regarding insurance, one can also write to the Insurance Division of the Securities and Exchange Commission of Pakistan (SECP) at following address.
Securities and Exchange Commission of Pakistan,
63-Jinnah Avenue, Blue Area,