Life Insurance Ombudsman Complaints: Insurer Scorecard (IRDAI 2022-25)
Updated 13 min read
Cheat Sheet
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15,342 life insurance complaints reached ombudsmen in FY 2024-25, down from 19,786 two years earlier.
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Bharti AXA alone accounted for 18% of all complaints (2,770 in FY 2024-25), more than LIC and HDFC Life combined among private insurers.
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Industry-wide complainant win rate fell to 41% in FY 2024-25 from 50.7% in FY 2022-23. The ombudsman is ruling for insurers more often.
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Outstanding cases nearly doubled from 1,206 to 2,237 in three years. The system is getting backlogged.
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Edelweiss Life (50.9%) and Bharti AXA (50.4%) had the highest complainant win rates in FY 2024-25; HDFC Life (31.3%) had the lowest among major insurers.
15,342
Life insurance complaints received by ombudsmen (FY 2024-25)
Down 22.5% from 19,786 in FY 2022-23
41.0%
Complainant win rate at ombudsman (FY 2024-25)
Down from 50.7% in FY 2022-23
2,770
Complaints against Bharti AXA alone (FY 2024-25)
More than any other single insurer, public or private
2,237
Cases still pending at year-end (FY 2024-25)
Up 85.6% from 1,206 in FY 2022-23
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.
If you file an ombudsman complaint, what are your odds of winning?
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.
Ombudsman complaint scorecard: all life insurers, FY 2024-25
| Insurer ⇅ | Complaints received ⇅ | Total disposed ⇅ | Awards for complainant ⇅ | Awards for insurer ⇅ | Complainant win rate ⇅ |
|---|---|---|---|---|---|
| Bharti AXA | 2,770 | 2,783 | 504 | 495 | 50.4% |
| LIC | 1,951 | 1,906 | 258 | 488 | 34.6% |
| HDFC Life | 1,320 | 1,288 | 136 | 298 | 31.3% |
| PNB MetLife | 1,060 | 1,058 | 127 | 231 | 35.5% |
| Bajaj Allianz Life | 998 | 930 | 103 | 140 | 42.4% |
Source: Council for Insurance Ombudsmen Annual Report, FY 2024-25. Win rate = awards for complainant / (awards for complainant + awards for insurer). Excludes recommendations, withdrawals, and non-entertainable cases. Acko Life, Go Digit Life, and Sahara Life excluded (near-zero complaint volumes).
What this means for you
The industry average win rate of 41% understates your real chances. When you add in mediated recommendations, nearly half of all complainants got some relief. But the odds vary wildly by insurer: Edelweiss Life and Bharti AXA policyholders won over 50% of the time, while HDFC Life complainants won just 31.3%. Before buying a policy, check how your insurer performs when disputes actually reach the ombudsman.
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 for you
The ombudsman system is getting slower. Outstanding cases nearly doubled in three years, and 381 cases have been pending for over a year for the first time. If you file today, budget for 6 months rather than the promised 3. Set a calendar reminder at the 3-month mark to follow up with your ombudsman centre, and keep consumer court as a backup if the wait stretches beyond 6 months.
What should you expect if you take your insurer to the ombudsman?
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.
What this means for you
When comparing term insurance policies, don’t stop at the claim settlement ratio. Check how many complaints each insurer generates at the ombudsman and how often the ombudsman rules against them. An insurer with a 98% CSR but high ombudsman complaint volumes (like Bharti AXA) may reject fewer claims overall yet handle the rejected ones poorly enough that policyholders escalate in large numbers.
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.
What this means for you
If your COVID-era death claim was rejected and the insurer’s grievance cell hasn’t resolved it, you can still file with the ombudsman. There is no statute of limitations on ombudsman complaints as long as the insurer’s final response (or 30-day silence) happened within the last year. Gather the rejection letter, policy documents, and medical records before filing.
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.
Frequently asked questions
What does “complainant win rate” mean in the ombudsman data?
It is the percentage of award decisions where the ombudsman ruled in favour of the policyholder. We calculate it as: awards for complainant divided by (awards for complainant + awards for insurer). This excludes recommendations (mediated settlements), withdrawals (complainant dropped the case), and non-entertainable cases (rejected before hearing). A 50% win rate means the ombudsman sided with the policyholder and the insurer equally often.
Can I go to the ombudsman if my term insurance claim is rejected?
Yes, but you must first file a grievance with the insurer and either receive a final response or wait 30 days. If unsatisfied, you can file a complaint with the insurance ombudsman in your jurisdiction. The complaint must be about a claim amount up to ₹50 lakh (increased from ₹30 lakh in 2021). There is no fee, and you do not need a lawyer. The ombudsman will attempt to mediate a settlement first, and if that fails, will pass a binding award.
Why did industry-wide ombudsman complaints drop from 19,786 to 15,342 over three years?
Several factors likely contributed. IRDAI has been pushing insurers to resolve complaints at the company level through the Bima Bharosa portal, which may have diverted some complaints away from the ombudsman. The sharp drop in Bharti AXA complaints (from 4,617 to 2,770) accounts for a large portion of the decline by itself. Industry-wide improvements in grievance handling and a reduction in aggressive sales practices after IRDAI’s 2023 guidelines may also have played a role.
Should I choose my insurer based on ombudsman win rates?
The ombudsman data is one of several inputs, not the sole decider. A low complaint volume with a high win rate might mean the insurer’s rejections are frequently overturned, but it could also reflect a small sample size. Combine this data with the insurer’s claim settlement ratio, court case track record, and solvency ratio for a fuller picture. The ombudsman scorecard is most useful as a red-flag detector: an insurer with high complaint volumes and high loss rates warrants extra scrutiny.
Check your insurer’s full report card
The ombudsman scorecard is one piece of the puzzle. Compare claim settlement ratios, court outcomes, and solvency data across all life insurers in our data-driven rankings.
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.
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Disclaimer: This article is for informational purposes only and does not constitute insurance advice. Consult an IRDAI-registered insurance advisor for recommendations tailored to your specific financial situation and needs.
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Reviewed and Edited by
Manan ShahManan Shah is a finance and economics writer with experience in research and analysis. His work centers on investments and personal finance, where he translates complex ideas into clear, practical insights for everyday readers. He has written extensively on mutual funds, market trends, and financial planning, with a strong focus on accuracy, clarity, and reader relevance.
