IOR Section 11 : Territorial jurisdiction of Insurance Ombudsman

Explanation using Example

Example 1: Territorial Jurisdiction and Ombudsman Sittings

Introduction: Mr. Sharma, a resident of Mumbai, has a dispute with his insurance company regarding a claim settlement. He wishes to file a complaint with the Insurance Ombudsman.

Application: According to Section 11, Sub-rule (1) and (2) of The Insurance Ombudsman Rules, 2017, the territorial jurisdiction of the Insurance Ombudsman is specified by the Council for Insurance Ombudsmen. Mr. Sharma needs to file his complaint with the Ombudsman who has jurisdiction over Mumbai.

Furthermore, as per Sub-rule (3), the Ombudsman can hold sittings at various places within his jurisdiction to expedite the disposal of complaints. If Mr. Sharma is unable to travel to the Ombudsman's main office, he can attend a sitting closer to his location if one is scheduled.

Outcome: Mr. Sharma files his complaint with the appropriate Ombudsman. The Ombudsman schedules a sitting in a nearby location, allowing Mr. Sharma to present his case without significant travel.

Conclusion: By understanding the territorial jurisdiction and the flexibility of Ombudsman sittings, Mr. Sharma efficiently addresses his insurance dispute.

Example 2: Handling a Vacancy in the Ombudsman Office

Introduction: Ms. Gupta, residing in Delhi, wants to file a complaint with the Insurance Ombudsman. However, she learns that the Ombudsman office in her jurisdiction is currently vacant.

Application: According to Section 11, Sub-rule (4) of The Insurance Ombudsman Rules, 2017, in case of a vacancy, the Council for Insurance Ombudsmen can authorize another Ombudsman to handle the functions of the vacant office for up to six months or until the vacancy is filled.

The Council, recognizing the public interest, assigns the Ombudsman from a neighboring jurisdiction to temporarily manage complaints from Delhi.

Outcome: Ms. Gupta is able to file her complaint with the authorized Ombudsman, ensuring her case is heard without undue delay.

Conclusion: The provision for handling vacancies ensures that citizens like Ms. Gupta continue to have access to the Ombudsman services, maintaining the efficiency and accessibility of the complaint resolution process.