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From SECP Website:

Federal Insurance Ombudsman

The appointment of the Insurance Ombudsman by the Federal Government is required under section 125 of the Insurance Ordinance, 2000 with the purpose of quick disposal of the grievances of the insured. This office is of great importance and relevance for the protection of interests of policy holders and also in building their confidence in the system. The office of the Insurance Ombudsman is an autonomous national dispute resolution body which independently and impartially resolves insurance disputes, between insurance policyholders and participating companies, absolutely free of cost. The office of the Insurance Ombudsman is fully operational since May 2006.

Further details regarding the Federal Insurance Ombudsman may be find at the official website : http://www.insuranceombudsman.gov.pk or through email to: info@insuranceombudsman.gov.pk.

Jurisdiction, Functions and Power

The Section 127, of the Insurance Ordinance, 2000 formulates operational parameters of the Office of the Insurance Ombudsman. The jurisdiction, functions and powers of the Insurance Ombudsman are summarized as under:

  • On request/ complaint of the aggrieved person, the Insurance Ombudsman may undertake any investigation into any allegation of maladministration, on part of any insurance company, provided that the matter is not with the Wafaqi Mohtasib (Federal Ombudsman), court of competent jurisdiction, tribunal or board in Pakistan. Mal-administration is defined by the Insurance Ordinance, 2000 as corruption, nepotism, neglect, inattention, inordinate delay, incompetence, inefficiency and ineptitude in the administration or discharge of duties and responsibilities.

  • The complaints brought in by the Insurance Companies, which relates to the contract of reinsurance or such sort, are not accepted by the Insurance Ombudsman office for investigation.

  • The Insurance Ombudsman office does not accept for investigation, any complaint by or on behalf of an employee of an insurance company, concerning any matter relating to the insurance company in respect of any personal grievance relating to his service with the company.

  • For ascertaining the root causes of corrupt practices and injustice, the Insurance Ombudsman is empowered to arrange studies/ research and may recommend appropriate steps for their eradication.

Procedure for Making Complaints

The procedure as laid down under Section 129 of the Insurance Ordinance, 2000 and is summarized as follows:

  • Before making a complaint the complainant is required to intimate in writing to the concerned insurance company his intention of filing a complaint.

  • If the insurance company either fails to respond, or makes a reply which is unsatisfactory to the complaint, within a period of one month, the complainant may file a complaint at any time after that within a further period of three months.

  • A complaint should be made on solemn affirmation or oath in writing addressed to the Insurance Ombudsman. The complaint shall set out the full particulars of the complaint matter and the name and address of the complainant.

  • Copy of the notice sent to the insurance company along with postal / courier receipt should also be attached with your complaint. In all cases, three (03) complete sets of complaint are required to be filed with the Ombudsman, the address and phone numbers are mentioned as under:

  • Mr. Azhar Ali Farooqi
    Insurance
    Insurance Ombudsman Secretariat
    Plot No.197/5, 2nd Floor
    Pakistan Red Crescent Society, Annexe Building
    Dr. Daud Pota Road
    Near Cantt. Station
    KARACHI.
    Contact Nos.: 021-99207762/63

Powers of the Insurance Tribunal

The Insurance Ordinance, 2000 confers following powers to the Tribunal:

  • The Tribunal has all the powers vested in a civil Court under the Code of Civil Procedure, 1908.
  • In its criminal jurisdiction, the Tribunal has the same powers as are vested in the Court of Sessions under the Code of Criminal Procedure, 1898.
  • The jurisdiction of a Tribunal shall not extend to appeals to the Appellate Bench and Courts, as mentioned in the section 33 and 34 of the SECP Act 1997.
Appeal against the Insurance Tribunal

The decision of the Tribunal on any application is final and cannot be questioned in any Court or before any other authority. If the amount of the claim is not less than one hundred thousand rupees, the aggrieved may file an appeal to the High Court, within a period of thirty days from the date of such decision. An appeal is heard by a Bench of more than two judges of the High Court, having territorial jurisdiction over the relevant Tribunal.