Anil, an individual, has taken with Urban Insurance Co. Ltd, a fire policy against his residential property, for a sum assured of ₹3,00,000. The cover lasts till the end of September, 2015. On 20th May, 2015, an accident

This question deals with dispute resolution between an insured and insurer. It is a case where an individual has insured a non-commercial building against fire losses for ₹3,00,000. A fire takes place and the building is completely gutted and destroyed. In other words, the property is completely lost and there is a total loss. The insurer, on receiving a claim has denied it on the ground of negligence on the part of the insured. The avenues open to Mr. Anil to resolve the disputes are discussed below: He can approach the Consumer Disputes Redressal Forum established by a State Government in each district of a State. These forums deal with cases of a value of upto ₹20,00,000. However, the complaint has to be filed within two years from the date of cause of action arising. State Consumer Forums entertain claims upto ₹1 crore and national forum of more than ₹1 crore. The forum has the power of a civil court. The forum can order and provide relief to the complainant. For insurance related claims, an additional separate window has been provided in the shape of insurance ombudsman who has been empowered to look into insurance related cases from non-corporate persons when the claim amount does not exceed ₹20 lakhs. A person who wants to approach the ombudsman must have approached first the insurance company and must have gone through the procedure regarding complaint redressal mechanism in house by the company. The IRDAI has provided a gateway of IGMS (Integrated Grievance Management System) in its website which provides an opportunity to any individual to log in the details of the compliant or grievance and thereby is informed on the follow up action taken by the Regulator and the company. Thereafter, the insured can approach the ombudsman if either the insurance company rejects the grievance or complaint or the insured is not satisfied with the decision of the insurer or the insurer fails to respond the complaint within one month of the submission of the grievance. No complaint can be filed with the ombudsman after one year from the date of rejection or the receipt of a final letter from the insurer. The insured should not have also filed complaint seeking legal remedies in alternate forum and those proceedings were not disposed off. After hearing both the insurer and the insured, the ombudsman will make his recommendation within one month from the date of receipt of the complaint. This will be followed by a trial order within three months. The ombudsman's order will be binding on the insurer but if the insured was not satisfied with the order he can choose to appeal against it. The insurer, within 15 days of the ombudsman order shall comply with it. The individual can also appeal against the award pronounced by the Ombudsman if he is not satisfied with the judgment in the Consumer forums. In the present case, the fire accident took place on May 20, 2015 and on the insured reporting to in-house grievance facility, the insurer rejected the claim. Anil has now two choices before him. Since the loss is less than ₹20 lakh, he can either approach the District Consumer Forum or go to the insurance ombudsman. The claim before the Consumer Forum will be civil litigation and will be time consuming. If Anil approaches the insurance ombudsman, the settlement process is quick around three or four months and if Anil at the end of the proceedings is not satisfied with the ombudsman's award, he can seek alternative remedies, like Consumer Forum, High Court, etc. Hence, it will be prudent for Anil to go to insurance ombudsman with the complaint. The cost of litigation will also be very low before the ombudsman.