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The ombudsman is vested with the powers to :
- Receive the complaint made by a person having a grievance against the insurer.
- Receive and deal with issues relating to any partial or total repudiation of claim by the insurer.
- To examine and decide any dispute in regard to premium paid or payable in terms of the policy of the insurance.
- To examine and decide any dispute on the legal construction of the policy.
- To examine the reasons as to delay in settlement of the claims.
- To examine the issues relating refusal to issue an insurance policy after the receipt of the premium by the insurer.
- To act as conciliator, adjudicator , or arbitrator in relation to references.
- To make award up to an amount of Rs. 20 Lakh in a disputed claim.
- To make ex-gratia payment , where the ombudsman deem fit.
The ombudsman shall examine all matters within the powers and jurisdiction , and on terms agreed to by the parties by mutual agreement. The decision of the ombudsman in relation to the question of complaint shall be final .
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