GRIEVANCE REDRESSAL PROCESS

Transcription

1 GRIEVANCE REDRESSAL PROCESS

2 PREFFACE Complaints are an opportunity for an organization to understand or identify gaps in any process, product or communication, work towards process improvements as well as cement the Company s relationship with dissatisfied customers. Complaint handling process is part of the customer care initiative. Regulation 5 of the Insurance Regulatory and Development Authority (Protection of Policyholders Interests) Regulations, 2002, prescribes that every insurer shall have in place proper procedures and effective mechanism to address complaints/grievances of policyholders efficiently and with speed. Further, IRDA s Guidelines for Grievance Redressal by Insurance Companies dated July 27, 2010 mandates time-frames, uniform definitions & classifications of complaints for grievance redressal by insurance companies. The purpose of this Grievance Redressal Process (hereafter referred to as the Process ) is to set forth the policies and procedures to be followed in receiving, handling and responding to any complaint/grievance against BSLI ( the Company ). This process encompasses complaints relating to all products issued by the Company and/or solicited by its agents or independent brokers. Products mentioned in this process will be referred to as policies, which encompasses all life insurance policies sold by the Company. Further, it is the Company s guiding principle to provide prompt and fair resolution of customer complaints in accordance with all legal and regulatory guidelines. It is imperative that the policies and procedures outlined in this process be fully understood and diligently followed by all employees, agents, independent brokers, and managerial personnel engaged in the Company s customer complaint handling process. Grievances received through consumer forums, courts, ombudsman s office, any judicial forum and legal notices shall be separately handled by our Legal/ relevant department. Exceptions would be entertained on case to case basis

3 Cllaassssiiffiiccaattiioon ooff Coompllaaiinttss,, IInquiirryy & Reequeesstt Inquiry is defined as any communication from a customer for the primary purpose of requesting for information about the Company or its services. Request is any communication from a customer soliciting a change/modification in the policy. Grievance/Complaint Is a communication or expression of dissatisfaction May be received either verbally or in writing Expresses a grievance from or on behalf of a customer Could be about: o An action or lack of action o The standard of service/deficiency of service Could be against any business practice followed by the Company or sales conduct of its agents/representatives/insurance intermediaries Can encompass anything that does not fall in either Inquiry or Request Complaint versus Inquiry / Request A complaint needs to be clearly differentiated from inquiry / request. Not every contact by a customer/policyholder questioning an action of the Company will constitute a complaint. Differentiating a complaint from an inquiry/request involves a reasonable application of judgment. The distinguishing factor should be the tone of the communication and a reasonable interpretation of it. If the tone is critical and the customer sounds unhappy or displeased about something, the communication should be treated as a complaint. A complaint includes allegations of some form of mis-selling, non-delivery of the policy, churning/twisting, failure to properly advise, misrepresentation or unsuitability of the product, delays in processing any client request like address change/premium payment/change in policy features, etc.

4 Coompllaaiintt ccaan bee rreeccoorrdeed aatt/ / wiitth 1. Call Centre: Customer can call at between 9:00am to 9:00pm (Monday to Saturday) and register their complaints. The call centre executive are also trained to resolve complaints over the phone by themselves 2. Website: BSLI website provides an option to the customer to log his Grievance on the internet & also provides guidance on BSLI s grievance handling procedure 3. Branch BSLI has 600 plus branches spread across pan India. The customer can visit and register his complaint at any of these branches 4. Advisor Customer gives his complaint to his servicing Advisor for resolution 5. Corporate Agents Customer registers his complaint with his Corporate Agent for resolution 6. Regulatory Bodies (Ombudsman/IRDA) In-case if the customer does not receive a satisfactory or a timely response from BSLI; customer has the option to report his complaint with the Regulators The above list is only illustrative and not comprehensive Moodee ooff Reequeessttss Letters. s, Telephonic Calls Walk-ins Web (BSLI website & IRDA web portal) Coompllaaiintt Reessoolluttiioon Prroocceessss On receiving any complaint, Customer Service will update the same in the CRM for investigation and resolution The Complaint will be categorized based on the Categories & Sub-Categories, as prescribed by IRDA from time to time (the latest version is attached herewith as Annexure A) Within 3 working days of receipt of the complaint/grievance, a written acknowledgement (viz. /letter) will be dispatched to the complainant containing: o A tentative timeline for resolution o The name & designation of the officer in the Grievance Handling team o Details of BSLI s grievance redressal procedure

5 After resolving the complaint, BSLI will immediately communicate the response (i.e. acceptance/ rejection) to the complainant in any case within 2 weeks from the date of the receipt of the complaint The response sent by Customer Service will also contain the following: o The process by which the complainant may pursue the complaint, if dissatisfied with the resolution o BSLI will consider the complaint as closed if the complainant does not revert to BSLI within 8 weeks from the date of BSLI s response communication Complaint will be treated as resolved if no revert is received from the complainant in 8 weeks The service turn-around-time to resolve the complaints will be as prescribed by IRDA for each of the Complaint categories from time to time. Clloossurree ooff Coompllaaiinttss As mandated by IRDA s Guidelines for Grievance Redressal by Insurance Companies dated July 27, 2010, a complaint will be considered as closed when: BSLI accepts the request of the complainant fully OR Complainant indicates in writing acceptance of BSLI s response OR Complainant has not responded to BSLI within 8 weeks of BSLI s response OR Grievance Redressal Officer has certified that the company has discharged its contractual, statutory and regulatory obligations and therefore closes the complaint Essccaallaattiioon Maattrriixx Any Complaint received by BSLI follows an escalation level matrix if not resolved as per the defined Turn-Around-Time. Levels Level 1 Level 2 Level 3 Level 4 Responsibility Vice President - Customer Service & Claims Compliance head Grievance Redressal Committee Ombudsman