A is an individual and owns extensive properties. He has insured them against comprehensive risks with a general insurer. One property X was insured for a sum of ₹ 8,00,000 against fire and incidental risks. The property

There are different forums open for an insured to consider his claim. For an insured to proceed with his claim in an outside forum, he has to exhaust internal procedure. He must make an representation to the insured's own grievance settlement mechanism that has been made obligatory for the insurer to establish and when the insured is not satisfied with the progress of the claim refer to forum or the forum must result, he has option to proceed further. The option open to him are civil courts and the common protection agencies are easiest method that has been prescribed by the IRDAI to conform to the Redressal of Public Grievances Rules, 1998 and approach the Insurance ombudsman. The ombudsman can step in cases where there is a partial or total representation of a claim by the insurer. Hence this procedure will be available to A. The dimensions of the ombudsman scheme make it very plain to an insured to adopt as an easy facility. The complaint with the ombudsman must be filed within one year from the date of rejection by the insurer or a first seller from the insurance company on the insured's representation. There is a two stage procedure followed by the ombudsman-viz an initial recommendation and then being not found acceptable or final award. Ombudsman's recommendation comes within a month of the date of receipt of the complaint by him and is after hearing both insured and insurer of the recommendation made by the ombudsman were to be acceptable to the parties, they could go ahead and settle the claim with the insurance company with the recommendation not later than 15 days of the receipt from the ombudsman. If the matter does not get settled at most stage the ombudsman shall after hearing the parties will pass an award in writing within three months of the receipt of the complaint and a copy of the award is sent to both the insurer and the insured. The award binds the insurance company but if the insured does not feel satisfied with the ombudsman's decision, he can further go for legal remedies in courts etc. One limiting factor of the ombudsman process is that the award can not exceeds ₹ 20.00 lacs and the matter should be non-commercial. It has been seen that the ombudsman path is the cheapest and quickest settlement path for the resolution of the dispute in re dispute claim. In the present case, the cover granted was non-commercial the subject matter insured was a property. The insurance cover was for ₹ 8.00 lacs. In the circumstances the advice for A will be file a complaint to the Insurance ombudsman after exhausting the approach to the internal dispute resolution of the insurance company.