Customers’ Grievances and Redressal Mechanism in the Indian Health Insurance Industry – An Analysis

Health insurance plans, being a complex financial product, needs a lot of understanding, awareness and updating among customers. Towards the end of March 2017, there are 29 General insurance players functioning in India; of which 4 are Public players, 17 are Private players, 2 specialized insurers and 6 are health insurance players absolutely doing health insurance business. The four public sector companies contribute 47% to the industry and the outstanding part is covered by the 17 private sector companies and 2 specialized insurers in 2016-17, and the share of the Health segment is 27%. Customer satisfaction is the key hole and customer retention is the critical and the main desire of every service oriented organization. Due to some fraudulent unethical practices by some of the Insurers in India, customer dissatisfaction and grievance are on the rise. The authorities are trying to create awareness among customers and to curb such unholy practices. So, an execution of the well-equipped Customer Relationship Management (CRM) and Grievance Redressal policy will support the companies to speedily raise the satisfaction and loyalty of customers. In order to remove various hurdles faced by the customers, the Insurance Regulatory and Development Authority (IRDA) issues guidelines regarding Grievance Redressal to the insurers. This study is diagnostic and exploratory in nature and essentially makes use of primary and secondary data. The study provides the details of the awareness regarding the grievances settlement operations, causes of dissatisfaction among customers, various measures taken to resolve the issues and data related to grievances in the health insurance industry. The study suggests that the health insurance industry need to create awareness among the customers with respect to redressal of their grievances and the policy holders need to be more alert while obtaining Health insurance products.