Gujarat Insurance Complaints: 4,314 Cases Reach Ahmedabad Ombudsman in 2024–25

The Insurance Ombudsman office in Ahmedabad received 4,314 complaints in 2024–25, more than four in five of them about health insurance. The office resolved 4,235 cases, and 1,140 verdicts went in the complainant’s favour.

The office’s jurisdiction extends beyond Gujarat to include Dadra and Nagar Haveli and Daman and Diu.

The state-level picture reflects a wider national trend. Across the country, over 26,600 complaints about insurance “mis-selling” and unfair business practices were registered during 2024–25, an increase of about 14% on the previous year. Insurance is bought for protection, yet the rising number of complaints continues to raise concern.

Health Insurance Accounts for Most Cases

Of the 4,314 complaints received by the Ahmedabad office, 3,540, or 82.06%, pertained to health insurance. The office also recorded 611 complaints about life insurance and 163 about general insurance.

Claim Rejections Top the List

The main reason for the complaints taken up for hearing was the full or partial rejection of claims. A total of 3,524 complaints, representing 91.56% of those taken up, fell into this category. Next came 301 complaints about the misrepresentation of policy terms.

Awards and Settlements

Among the resolved cases, 1,140 ended in verdicts favouring the complainant, while 1,346 were settled through mediation or recommendations. The total value of recommendations and awards made in favour of complainants stands at ₹18.67 crore.

Mis-selling and the Sales Model

The complaints about misrepresented policy terms tie into the national discourse on “mis-selling”. Insurance companies do not sell policies directly to customers. Instead, policies are sold through an extensive distribution network of agents, banks, corporate agents, brokers, web aggregators and vehicle dealers. The regulator continues to monitor the balance between customer needs and sales incentives in this commission-based model.

Ahmedabad Office at a Glance (2024–25)