PPGR & Claims Monitoring Committee: Board-Level Insurance Grievance Governance Checklist
By Ravi Sisodia · Reviewed by CA Divyanshu Sengar · Updated 5 October 2026
2-minute summary
- The PPGR & Claims Monitoring Committee is a board-level insurer governance control, not a customer complaint desk.
- IRDAI’s 2024 corporate-governance framework requires insurers, other than the stated reinsurance exception, to constitute the committee with an Independent Director as chairperson.
- The committee should turn complaint, mis-selling, claims and Ombudsman/consumer-forum data into root-cause actions, service standards and Board oversight.
Current position
Control and evidence map
| # | Control / evidence requirement | |
|---|---|---|
| 1 | Approve and monitor SOPs for fair treatment, grievance handling and policy/claim servicing TATs. | |
| 2 | Review complaint volumes, ageing, repeat causes, mis-selling indicators and closure quality - not only aggregate closure percentages. | |
| 3 | Monitor claims settlement patterns, repudiations, outstanding ageing and customer-pay-out issues. | |
| 4 | Track Ombudsman/consumer-forum awards, delayed implementation and recurring legal/operational causes. | |
| 5 | Escalate systemic issues to Board/management owners with dated remediation, control testing and closure evidence. | |
Worked example
An insurer shows 98% complaint closure, but a segment analysis reveals repeated claim repudiations caused by the same proposal-data mapping error. The PPGR&CM committee should not accept the headline closure rate; it should commission root-cause correction, test affected policies and track remediation to closure.
Common mistakes
- Treating the committee as a quarterly presentation forum with no action register.
- Monitoring complaint counts without severity, ageing or repeat-cause analysis.
- Ignoring mis-selling complaints because they sit with distribution rather than claims.
- Closing Ombudsman implementation items without proof of payment or customer correction.
Frequently asked questions
Who chairs the committee?
The 2024 governance framework requires the chairperson to be an Independent Director.
Is it mandatory for every insurer?
The regulations provide an exception for companies whose sole purpose is reinsurance business.
What should management bring to the committee?
Trend, ageing, root-cause, claims, awards and remediation evidence - not just volumes.
Why does this matter to policyholders?
Board oversight is meant to make grievance and claims processes more effective and identify systemic conduct problems.
Official sources
- Insurance Regulatory and Development Authority of India - Master Circular on Corporate Governance for Insurers, 2024 (IRDAI/F&I/CIR/MISC/82/5/2024; 2024-05-22)
- Insurance Regulatory and Development Authority of India - Master Circular on Protection of Policyholders Interests, 2024 (IRDAI/PP&GR/CIR/MISC/117/9/2024; 2024-09-05)
- Insurance Regulatory and Development Authority of India - Bima Bharosa grievance call-centre and process guidance (Current portal guidance; current)
Disclaimer
Educational and professional reference only; confirm the current law, rates and the facts of your case before relying on this page.