IOR Section 15 : Insurance Ombudsman to Act Fairly and Equitably
Act
Summary
Section 15 of the Insurance Ombudsman Rules, 2017, mandates that the Insurance Ombudsman act fairly and equitably in handling complaints. The Ombudsman may allow alternative complaint procedures and request additional documents to support claims. They can also seek expert opinions and conduct hearings via video conference when necessary, ensuring all parties have a reasonable opportunity to be heard.
JavaScript did not load properly
Some content might be missing or broken. Please try disabling content blockers or use a different browser like Chrome, Safari or Firefox.
Explanation using Example
Example 1: Alternative Procedure for Filing a Complaint
Introduction: Sarah, a policyholder, faces a dispute with her insurance company regarding a claim denial. She is unfamiliar with the formal complaint procedures outlined in Rule 14 of The Insurance Ombudsman Rules, 2017.
Application: According to Section 15(1) of The Insurance Ombudsman Rules, 2017, the Ombudsman has the discretion to allow Sarah to adopt a different procedure for filing her complaint, provided all parties are notified. In this case, the Ombudsman decides that Sarah can submit her complaint via a simplified online form, which is more accessible for her.
Outcome: By allowing an alternative procedure, the Ombudsman ensures that Sarah's complaint is heard without the procedural barriers that might have otherwise discouraged her from pursuing her claim. This flexibility helps maintain fairness and accessibility in the complaint process.
Conclusion: This example illustrates how the Ombudsman can facilitate access to justice by adapting procedures to suit the complainant's needs, ensuring that the process remains fair and equitable.
Example 2: Gathering Additional Information
Introduction: John, an insurance broker, is involved in a dispute with an insurer over the terms of a policy sold to a client. The insurer claims that John misrepresented certain policy details.
Application: Under Section 15(2) of The Insurance Ombudsman Rules, 2017, the Ombudsman can request additional documents from both parties to support their claims. The Ombudsman asks John to provide email correspondence with the client and the insure...
Login to access all pages and read more content.
To disable ads and read rest of the premium content, subscribe to KanoonGPT Pro.
Download Digital Bare Acts on mobile or tablet with "Kanoon Library" app
