FAQ: How to Find Your Insurance Ombudsman in Every Country
Need to escalate an insurance dispute? Find the correct insurance ombudsman, complaints authority, or external review body for the US, UK, Australia, Singapore, Malaysia, Canada, Ireland, and other countries.
FAQ: How to Find Your Insurance Ombudsman in Every Country
An insurance ombudsman (or equivalent independent dispute resolution body) is a free, independent service that reviews insurance disputes and can require insurers to pay valid claims. They are one of the most powerful tools available to insurance policyholders — and most people don't know they exist.
This guide tells you exactly where to go for independent dispute resolution in your country.
United States
The US doesn't have a single national insurance ombudsman, but equivalent functions are performed by:
External Review (Health Insurance)
Who: Independent Review Organisations (IROs) appointed by state insurance commissioners When: After exhausting internal appeals Cost: Free How to access: Contact your insurer and request external review initiation after a final adverse determination Binding: Yes — IRO decisions are binding on the insurer
Federal external review (self-insured ERISA plans): Contact your insurer for federal external review initiation, or contact the Department of Labor's Employee Benefits Security Administration at dol.gov/agencies/ebsa
State Departments of Insurance
Who: State insurance regulators in each US state What: Investigate insurer misconduct and unfair claims practices How to find: National Association of Insurance Commissioners at naic.org — click "State Insurance Regulators" Cost: Free
Major state insurance departments:
- California: insurance.ca.gov
- New York: dfs.ny.gov
- Texas: tdi.texas.gov
- Florida: myfloridacfo.com/division/consumers
- All states: find at naic.org
Medicare Specific
- Medicare ombudsman: 1-800-MEDICARE (1-800-633-4227)
- State Health Insurance Assistance Programs (SHIP): Free Medicare counselling — find at shiptacenter.org
- Medicare complaint: medicare.gov/complaint
Medicaid Specific
- State Medicaid ombudsman: Each state has one; find through your state Medicaid agency
- Medicaid.gov: medicaid.gov
TRICARE
- TRICARE Service Centres at military installations
- Defense Health Agency: tricare.mil
United Kingdom
Financial Ombudsman Service (FOS)
- Website: financial-ombudsman.org.uk
- Phone: 0800 023 4567 (free from landlines and mobiles)
- Email: complaint.info@financial-ombudsman.org.uk
- What it covers: All FCA-regulated financial products including health, life, critical illness, income protection, car, home, and travel insurance
- When to use: After the insurer's Final Response (or 8 weeks without a Final Response)
- Cost: Free for consumers
- Binding: Yes — FOS decisions are binding on the insurer if you accept them
Financial Conduct Authority (FCA)
- For regulatory concerns about insurer conduct
- Website: fca.org.uk
- Phone: 0800 111 6768
Insurance & Long Term Care (ILC) UK
- For information and guidance on insurance disputes
Australia
Australian Financial Complaints Authority (AFCA)
- Website: afca.org.au
- Phone: 1800 931 678 (free)
- What it covers: All financial services complaints including all types of insurance
- When to use: After attempting resolution with the insurer
- Cost: Free for consumers
- Binding: Yes — AFCA decisions are binding on financial service providers
Private Health Insurance Ombudsman (PHIO)
- Website: ombudsman.privatehealth.gov.au
- Phone: 1800 640 695 (free from landlines)
- Email: phio@phio.gov.au
- What it covers: Private health insurance disputes specifically
- Cost: Free
- Authority: Can direct health funds to reverse incorrect decisions
Australian Securities and Investments Commission (ASIC)
- Regulatory body for insurance conduct
- Website: asic.gov.au
State health and insurance ombudsmen: Some Australian states also have ombudsmen handling government insurance schemes.
Singapore
Financial Industry Disputes Resolution Centre (FIDREC)
- Website: fidrec.com.sg
- Phone: 6327 8878
- Address: 36 Robinson Road, #15-01 City House, Singapore 068877
- What it covers: Disputes with financial institutions including all insurance types
- Jurisdiction: Up to S$100,000 (varying by claim type)
- Filing fee: S$50 (refundable if you succeed)
- Binding: Yes — adjudication decisions are binding on financial institutions
Life Insurance Association (LIA) Singapore
- Website: lia.org.sg
- Claims Conciliation Panel: Free mediation for life and critical illness insurance disputes
General Insurance Association (GIA) Singapore
- Website: gia.org.sg
- For general insurance (motor, travel, property) guidance
Monetary Authority of Singapore (MAS)
- For regulatory complaints about licensed insurers
- Website: mas.gov.sg/complaints
Malaysia
Ombudsman for Financial Services (OFS)
- Website: ofs.org.my
- Phone: 03-2272 2811
- Email: enquiry@ofs.org.my
- Address: Level 14, Main Block, Menara Takaful Malaysia, No. 4, Jalan Sultan Sulaiman, 50000 Kuala Lumpur
- What it covers: All financial services complaints including insurance and takaful
- Jurisdiction: Up to RM 250,000
- Cost: Free for consumers
- Binding: Yes — decisions are binding on financial institutions
Bank Negara Malaysia (BNM) BNMLINK
- Phone: 1-300-88-5465
- Email: bnmlink@bnm.gov.my
- Website: bnm.gov.my
- For regulatory complaints about licensed insurers
Credit Counselling and Debt Management Agency (AKPK)
- Primarily for debt management but can provide referrals for insurance disputes
Canada
OmbudService for Life & Health Insurance (OLHI)
- Website: olhi.ca
- Phone: 1-888-295-8112 (English) / 1-866-851-8090 (French)
- What it covers: Life, health, and travel insurance disputes in Canada
- Cost: Free
- Binding: Not formally binding but insurers typically comply with recommendations
General Insurance OmbudService (GIO)
- Website: giocanada.org
- What it covers: General insurance (home, auto, commercial) disputes
- Cost: Free
Financial Consumer Agency of Canada (FCAC)
- Website: fcac-acfc.gc.ca
- Regulatory oversight and consumer education
Provincial Insurance Regulators: Each province has its own insurance regulator:
- Ontario: fsrao.ca
- BC: bcfsa.ca
- Quebec: lautorite.qc.ca
- Alberta: dba.alberta.ca
Ireland
Financial Services and Pensions Ombudsman (FSPO)
- Website: fspo.ie
- Phone: 01 567 7000
- What it covers: All financial services including insurance
- Cost: Free
- Binding: Yes — FSPO decisions are binding on financial service providers
Central Bank of Ireland
- Regulatory oversight of insurers
- Website: centralbank.ie
New Zealand
Insurance & Financial Services Ombudsman (IFSO)
- Website: ifso.nz
- Phone: 0800 888 202
- What it covers: Insurance and financial services disputes
- Cost: Free
- Binding: Yes — IFSO decisions are binding on member firms
Hong Kong
Insurance Authority (IA)
- Website: ia.org.hk
- Phone: 3899 9983
- Insurance Claims Complaints Bureau (ICCB): Provides mediation for personal lines insurance disputes
Financial Dispute Resolution Centre (FDRC)
- Website: fdrc.org.hk
- Handles financial services disputes including insurance
South Africa
Ombudsman for Long-Term Insurance (OSTI)
- Website: ombud.co.za
- Phone: 0860 103 236
- What it covers: Life, disability, and health insurance
Ombudsman for Short-Term Insurance (OSTI)
- Website: osti.co.za
- Phone: 0860 726 890
- What it covers: Car, home, travel, and personal accident insurance
India
Insurance Regulatory and Development Authority (IRDAI)
- Website: irdai.gov.in
- Insurance Ombudsman: Regional offices across India; complaints from policyholders against insurers
- Website for complaints: igms.irda.gov.in
When to Contact the Ombudsman
Use the ombudsman when:
- You've submitted a formal complaint to the insurer
- The insurer has issued a Final Response that doesn't resolve the dispute
- OR the required response period has passed without resolution (typically 8 weeks UK, 60 days US/Malaysia, etc.)
- The claim falls within the ombudsman's jurisdictional limits
Conclusion
An insurance ombudsman is free, independent, and has genuine authority to require insurers to pay valid claims. Don't exhaust yourself fighting the insurer alone — use these bodies. Use ClaimBack at claimback.app to generate a professional appeal letter and to identify the specific ombudsman or external review body relevant to your country and insurer.
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