Project on

INSURANCE OMBUDSMAN

Bachelor of Commerce (Banking & Insurance) Semester IV (2011-2012)

Submitted

By SUVARNA YADAV Roll no.41

BIRLA COLLEGE OF ARTS, SCIENCE, COMMERCE Murbad Road, Kalyan

UNIVERSITY OF MUMBAI 2011 2012

BIRLA COLLEGE OF ARTS, SCIENCE, & COMMERCE, KALYAN (Conducted by Kalyan Citizens Education Society) (Affiliated by University of Mumbai)

BACHELOR OF BANKING AND INSURANCE

CERTIFICATE

This is to certify that MISS. SUVARNA YADAV of S.Y.B.Com (Banking & Insurance) (IV Semester) has successfully completed the project on INSURANCE OMBUDSMAN, under the guidance of MISS. RINKY RAJWANI.

Project Guide Course Co-ordinator Internal Examiner External Examiner

Principal

DECLARATION

I, SUVARNA YADAV, student of S.Y.B.Com Banking & Insurance semester IV (2011-2012) hereby declare that I have completed the project on INSURANCE OMBUDSMAN. I further declare that the information imparted is true and fair to the best of my knowledge.

SIGNATURE

SUVARNA YADAV Roll no.41

ACKNOWLEDGEMENT
I hereby express my heartiest thanks to all sources who have contributed to the making of this project. I oblige thank to all those who have supported, provided their valuable guidance and helped for the accomplishment of this project. I am very much grateful to my project guide Miss. Rinky Rajwani who inspite of her busy schedule spent her valuable time on this project. I am thankful to Mumbai University for giving me such a challenging task to explore the urbanization which includes not only thinking and analyzing various facts and updates about real work. I would also like to thanks our coordinator Mr. Anand Dharmadikari and our principal Dr. Naresh Chandra. I also extent my hearty thanks to my family, friends, and all the well wishers.

INDEX

Sr.No Preface 1 2 3 4 5 6 7 Introduction Ombudsman

CONTENTS

Pg.No

1 2-6 7-8 9 10-12 13-16 17-23 24 25 26

Types of Ombudsman Insurance Ombudsman Scheme of insurance ombudsman Functioning of the offices of the insurance ombudsman Filing complaint with insurance ombudsman Conclusion Wibliography Annexure

PREFACE
OBJECTIVES
To present Insurance Ombudsman Scheme & how it works. To present the services of the Banking Ombudsman offered to the customer. To show how the Banking Ombudsman deals with customer complaints. To explain the duties, functions & powers of the Ombudsman.

METHODLOGY
Secondary data Secondary data refers to information that has previously been gathered by someone other than the researcher or for the same purpose at hand. It is collected from Magazines, Internet, books.

In some countries an Inspector General, Citizen Advocate or other official may have duties similar to those of a national ombudsman, and may also be appointed by the legislature. Below the national level an ombudsman may be appointed by a state, local or municipal government, and unofficial ombudsmen may be appointed by, or even work for, a corporation such as a utility supplier or a newspaper, for an NGO, or for a professional regulatory body. Making a complaint to an ombudsman is usually free of charge.

ORIGINS AND ETYMOLOGY

The origin of the word is found in Old Norse umbusmann and the word umbuds man, meaning representative (with the word umbud/ombud meaning proxy, that is someone who is authorized to act for someone else, a meaning it still has in the Scandinavian languages). The first preserved use is in Sweden. In the Danish Law of Jutland from 1241 the term is umbozman and means a royal civil servant in a hundred. From 1552, it is also used in the other Scandinavian languages such as the both Icelandic and Faroese umbosmaur, the Norwegian ombudsmann and the Danish ombudsmand. The modern use of the term began in Sweden, with the Swedish Parliamentary Ombudsman instituted by the Instrument of Government of 1809, to safeguard the rights of citizens by establishing a supervisory agency independent of the executive branch. A prototype of ombudsmen may have flourished in China during the Qin Dynasty (221 BC), and in Korea during the Joseon Dynasty.The Roman Tribune had some similar roles, with power to veto acts that infringed upon the Plebians. The predecessor of the Swedish Parliamentary Ombudsman was the Office of Supreme Ombudsman ("Hgste Ombudsmannen"), which was established by the Swedish King, Charles XII, in 1713. Charles XII was in exile in Turkey and needed a representative in Sweden to ensure that judges and civil servants acted in accordance with the laws and with their duties. If they did not do so, the Supreme Ombudsman had the right to prosecute them for negligence. In 1719 the Swedish Office of Supreme Ombudsman became the Chancellor of Justice. One inspiration to the Supreme Ombudsman may have been the Turkish Diwan-al-Mazalim which appears to go back to the second Caliph, Umar (634-644) and the concept of Qadi al-Qadat. However, the current predecessor of ombudsman institutions, the Swedish Parliamentary Ombudsman, is based on the concept of separation of powers as developed by Montesquieu, which has a western origin and roots in the Enlightenment. The Parliamentary Ombudsman was established in 1809 by the Swedish Riksdag, as a parallel institution to the still-present Chancellor of Justice. The Parliamentary Ombudsman is the institution that the Scandinavian countries subsequently molded into its contemporary form, and which subsequently has been adopted in many other parts of the world.

IN POLITICS
In general, an ombudsman is a state official appointed to provide a check on government activity in the interests of the citizen, and to oversee the investigation of complaints of improper government activity against the citizen. If the ombudsman finds a complaint to be substantiated,

the problem may get rectified, or an ombudsman report is published making recommendations for change. Further redress depends on the laws of the country concerned, but this normally involves financial compensation. Ombudsmen in most countries do not have the power to initiate legal proceedings or prosecution on the grounds of a complaint. This role is sometimes referred to as a "tribunitian" role, and has been traditionally fulfilled by elected representatives the term refers to the ancient Roman "tribunes of the plebians" (tribuni plebis), whose role was to intercede in the political process on behalf of common citizens. The major advantage of an ombudsman is that he or she examines complaints from outside the offending state institution, thus avoiding the conflicts of interest inherent in self-policing. However, the ombudsman system relies heavily on the selection of an appropriate individual for the office, and on the cooperation of at least some effective official from within the apparatus of the state. Perhaps for this reason, outside Scandinavia, the introduction of ombudsmen has tended to yield mixed results.

IN ORGANIZATIONS
Many private companies, universities, non-profit organizations and government agencies also have an ombudsman (or an ombuds office) to serve internal employees, and managers and/or other constituencies. These ombudsman roles are structured to function independently, by reporting to the CEO or board of directors and according to International Ombudsman Association (IOA) Standards of Practice do not serve any other role in the organization. They are beginning to appear around the world within organizations, sometimes as an alternative to anonymous hot-lines in countries where these are considered inappropriate or are illegal, and in addition to hot lines because ombuds offices typically receive many more calls than do hot lines.(See Charles L. Howard, The Organizational Ombudsman: Origins, Roles and Operations, a Legal Guide, ABA, 2010). Since the 1960s, the profession has grown in the United States, and Canada, particularly in corporations, universities and government agencies. This current model, sometimes referred to as an organizational ombudsman, works as a designated neutral party, one who is high-ranking in an organization, but who is not considered part of executive management in the sense of being able to make management decisions. Using an alternative dispute resolution (ADR) sensibility, or perhaps more apt, an appropriate dispute resolution sensibility, an organizational ombudsman can provide options to whistleblowers or employees and managers with ethics concerns; provide coaching, shuttle diplomacy, generic solutions (meaning a solution which protects the identity of one individual by applying to a class of people, rather than just for the one individual) and mediation for conflicts; track problem areas; and make recommendations for changes to policies or procedures in support of orderly systems change. (It may be of interest that the term appropriate, as in appropriate dispute resolution, is something of a term of art. ADR is usually thought to be alternative dispute resolution, as in an alternative to formal, rights-based processes, including formal grievance procedures and the courts. It usually is thought to include mediation and arbitration. However, the word "appropriate" in this context includes rights- or rights- and power based dispute resolution. For example, appropriate dispute resolution of a work-place assault might be a formal grievance procedure or an appeal to