Ombudsman Complaint Scorecard: Which Life Insurers Lose the Most Disputes?

When your life insurance claim gets rejected and the insurer’s grievance cell shrugs you off, your next stop is the insurance ombudsman. The Council for Insurance Ombudsmen (CIO) runs 17 centres across India where policyholders can file complaints against insurers for free. No lawyers needed. No court fees. Just a written complaint and supporting documents.

The ombudsman hears both sides and either mediates a recommendation or passes a binding award. The insurer must comply with an award; you don’t have to accept it if you want to pursue the case in consumer court instead.

Every year, the CIO publishes a breakdown of how many complaints each insurer received, how many were decided, and who won. We pulled three years of this data (FY 2022-23 through FY 2024-25) and calculated complainant win rates for every life insurer in India. The results tell you which insurers are losing the most disputes at the ombudsman’s table, which ones are getting better, and which are getting worse.

If you’re comparing insurers for a term insurance policy, this data belongs in your decision alongside the claim settlement ratio ranking and court case analysis. A high CSR is one thing. But when claims do get rejected, what happens at the ombudsman? That’s what this scorecard answers.

The numbers at a glance (FY 2024-25)

This table covers every life insurer with ombudsman data for FY 2024-25. “Win rate” is the percentage of decided cases (awards only, excluding recommendations and withdrawals) where the ombudsman ruled in favour of the policyholder. Higher means the insurer lost more often.

A few things jump out from this table. Bharti AXA received 2,770 complaints, nearly double the second-highest private insurer (HDFC Life at 1,320). LIC, with its massive policyholder base, had 1,951. And the complainant win rate varies wildly, from a coin-flip 50.9% at Edelweiss Life down to 31.3% at HDFC Life among major insurers.

Which insurers lose most often?

The complainant win rate tells you how often the ombudsman sided with the policyholder over the insurer when deciding a case by award. A higher win rate means the insurer was found wrong more often.

Edelweiss Life tops the chart at 50.9%. When a policyholder’s complaint against Edelweiss went to an award decision, the ombudsman sided with the policyholder more often than not. Of 230 total awards, 117 went to the complainant and 113 to the insurer.

Bharti AXA is close behind at 50.4%, but the scale is completely different. Edelweiss had 230 awards total; Bharti AXA had 999. The volume of complaints and adverse findings against Bharti AXA dwarfs the rest of the industry. More on that below.

At the other end, HDFC Life’s 31.3% win rate means the ombudsman sided with the insurer in nearly 7 out of 10 award decisions. ICICI Prudential (34.4%) and LIC (34.6%) are in a similar range. Lower win rates can mean the insurer was right to reject most claims that reached the ombudsman, or that the insurer’s legal team is more effective at presenting its case. The data alone doesn’t tell you which.

The Bharti AXA story

No single insurer dominates the ombudsman data like Bharti AXA. The three-year picture:

In FY 2022-23, Bharti AXA received 4,617 complaints. The second-highest private insurer that year was HDFC Life with 1,663. Bharti AXA had nearly three times as many. And the complainant win rate was 66.7%, meaning the ombudsman ruled against Bharti AXA in two out of three decided cases.

By FY 2024-25, complaints dropped to 2,770 (a 40% decline). The win rate also fell dramatically from 66.7% to 50.4%. That FY 2023-24 dip to 38.3% is interesting; Bharti AXA’s awards for insurer spiked to 809 that year, up from 441 the previous year, even as complaints dropped. One possible explanation: many of the FY 2023-24 decisions involved legacy policies, and the insurer may have tightened its grievance handling process. By FY 2024-25, the win rate climbed back to 50.4%, which is still the second-highest among all insurers.

The outstanding case pile tells another story. Bharti AXA started FY 2022-23 with 264 outstanding cases, and by the end of FY 2024-25, it still had 503 pending. Even as new complaints dropped, the ombudsman system hasn’t been able to clear the backlog.

For context: Bharti AXA merged with SBI Life’s parent entity in some product lines, and the complaints likely relate to bancassurance-heavy distribution channels where policies may have been mis-sold. The CIO data doesn’t break down complaint reasons, so this is worth watching alongside IRDAI’s mis-selling enforcement data. If you ended up with a Bharti AXA policy you didn’t fully understand, the ombudsman route has historically been more favourable to complainants against this insurer than against others.

Three-year trends: who is improving, who is getting worse

Looking at complaint volume and win rate changes from FY 2022-23 to FY 2024-25 reveals which insurers are moving in the right direction and which are heading the other way.

The good news: The four biggest complaint generators in FY 2022-23 (Bharti AXA, LIC, HDFC Life, PNB MetLife) all saw significant declines. Industry total complaints dropped from 19,786 to 15,342, a 22.5% fall. Exide Life’s drop from 479 to 23 reflects its merger wind-down rather than improved practices.

The bad news: Several insurers are moving sharply in the wrong direction. Bajaj Allianz went from 562 complaints to 998 (+77.6%). Tata AIA nearly doubled from 327 to 628 (+92.0%). Kotak Life jumped from 323 to 555 (+71.8%). These are big percentage increases, and they happened while the industry average was falling.

When a company’s complaint volume rises while the industry declines, it usually points to specific operational problems: aggressive sales practices, tighter claim underwriting, or poor grievance handling at the company level. The data doesn’t tell you which, but the pattern should make prospective buyers take a harder look at the insurer’s claim settlement record before buying.

Win rate trajectory

The industry-wide complainant win rate dropped from 50.7% (FY 2022-23) to 36.1% (FY 2023-24) and then recovered partially to 41.0% (FY 2024-25). The FY 2023-24 dip is striking and requires some explanation.

One factor: the proportion of cases resolved through “recommendations” (mediated settlements where both parties agree, rather than awards) increased from 2,739 in FY 2022-23 to 4,734 in FY 2023-24 to 5,167 in FY 2024-25. When more complaints get settled through mediation, fewer reach the award stage. The cases that do reach an award tend to be harder-fought, where the insurer has a stronger defence. This likely pulled down the complainant win rate.

A few individual insurer shifts stand out:

• Kotak Life: Win rate jumped from 27.0% (FY 2022-23) to 35.8% (FY 2024-25). The ombudsman is ruling against Kotak more often than before, even as its complaint volume also surged.
• Bharti AXA: Win rate dropped from 66.7% to 50.4%. Still the second-highest, but the gap is narrowing.
• Tata AIA: Win rate rose from 41.0% (FY 2022-23) to 42.3% (FY 2024-25), with complaint volume nearly doubling. Both more complaints and a stable-to-rising loss rate.
• SBI Life: Win rate fell from 38.3% to 37.9%, roughly stable, while complaints declined from 1,082 to 534.

The growing backlog

Even as complaint volumes dropped, the system is disposing fewer cases than it receives. Here are the numbers:

In FY 2022-23, the system managed to dispose more cases (19,875) than it received (19,786). By FY 2024-25, it disposed only 15,000 against 15,342 received, while also carrying forward 1,894 from the previous year. The backlog is growing by about 340-690 cases per year.

The most alarming number in that table: 381 cases pending for more than one year as of March 2025. In FY 2022-23 and FY 2023-24, that number was zero. The ombudsman system was designed to resolve complaints within 3 months. A year-plus backlog means the system’s capacity has not kept pace with case complexity, even though raw volume declined.

Where is the backlog concentrated? Bharti AXA alone accounts for 503 of the 2,237 outstanding cases (22.5%), with 86 of those pending for over a year. HDFC Life has 174 outstanding (18 over a year). Bajaj Allianz has 151 outstanding (19 over a year). IndiaFirst has 169 outstanding (44 over a year, the second-highest).

If you’re filing a complaint today, be prepared for a wait. The older the backlog gets, the longer your case is likely to sit in queue. You might consider sending a follow-up to the ombudsman office if your case crosses the 3-month mark, and explore consumer court if it crosses 6 months without resolution.

What this means if you file a complaint

The ombudsman data gives you a few practical takeaways as a policyholder.

Your odds are roughly 4 in 10. The industry-wide complainant win rate was 41.0% in FY 2024-25. That’s not a coin flip, but it’s not hopeless either. When you add in the 5,167 cases resolved through recommendations (where the insurer agreed to a mediated outcome), your chances of getting some relief are better than the win rate alone suggests. In FY 2024-25, a total of 7,359 cases out of 15,000 disposed (49.1%) ended with either an award for the complainant or a recommendation. Nearly half the people who went to the ombudsman got at least a partial outcome in their favour.

Your insurer matters. If your complaint is against Edelweiss Life or Bharti AXA, history shows the ombudsman has ruled against these insurers more often than the industry average. If it’s against HDFC Life or ICICI Prudential, the insurer’s track record at the ombudsman is stronger. This shouldn’t discourage you from filing; it should calibrate your expectations.

The process is free but slow. No fees, no lawyers required. You need to exhaust the insurer’s internal grievance process first (or wait 30 days after filing a grievance). Then you file with the ombudsman. The intended timeline is 3 months. The reality, given the backlog, could be 6 months or longer. Keep your documents organised and follow up if the 3-month window passes.

The ombudsman’s decision is binding on the insurer, not on you. If the ombudsman rules against you, you can still go to consumer court. If the ombudsman rules in your favour, the insurer must comply. This makes the ombudsman a sensible first stop before committing to a longer and more expensive court process. For more on how court cases play out, see our NCDRC analysis of life insurance disputes.

COVID-era claims are still trickling through. Some of the complaints in FY 2024-25 relate to COVID-era claim rejections that took years to exhaust internal grievance processes before reaching the ombudsman. If you have a pending COVID claim that was rejected, the ombudsman route is still open.

If you’re new to term insurance and choosing an insurer, the ombudsman scorecard is one of several data points you should weigh. A company that loses fewer disputes at the ombudsman isn’t necessarily better; it could just mean fewer policyholders file complaints, or the ones who do have weaker cases. But a company with a high complaint volume and a high loss rate (Bharti AXA, for instance) is a pattern you can’t ignore.

Methodology

All data is from the Council for Insurance Ombudsmen (CIO) Annual Reports for FY 2022-23, FY 2023-24, and FY 2024-25. We used only the life insurance segment data. “Complainant win rate” is calculated as awards_for_complainant / (awards_for_complainant + awards_for_insurer) for each insurer-year. This excludes recommendations (mediated settlements where both parties agree), withdrawals (complainant withdrew the complaint), and non-entertainable cases (complaints rejected before hearing, typically for jurisdictional or procedural reasons). Insurers with fewer than 15 total awards across three years (Acko Life, Go Digit Life, Sahara Life) are excluded from analysis. Percentage changes are calculated on raw complaint-received figures. All numbers are verifiable against the original CIO reports at cioins.co.in.