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Insurance Claim Rejection - बीमा शिकायत कैसे करें

Insurance claim reject होने पर complaint कैसे करें - IRDA process

Category
Insurance
Updated
15 May 2026
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979
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Quick Summary

Insurance complaints need policy wording, claim forms, rejection letters, and hospital or repair documents.

Complete Guide

Insurance claim reject हो गया? IRDA Ombudsman के through complaint करें। Ye guide insurance disputes के लिए है। **Common Insurance Issues:** - Claim rejection - Delayed claim settlement - Mis-selling of policies - Premium disputes - Policy cancellation issues - Poor service quality **Documents Needed:** - Policy document - Claim rejection letter - Medical reports (health insurance) - Communication with insurance company - Premium payment receipts **Process:** - First approach insurance company - Wait for 30 days - Then file IRDA complaint

Step-by-Step Process

  1. 1Insurance company को written complaint भेजें
  2. 2Complaint acknowledgment लें
  3. 330 days wait करें company response के लिए
  4. 4IRDA Ombudsman portal पर जाएं
  5. 5Online complaint form भरें
  6. 6Policy details enter करें
  7. 7Rejection reason explain करें
  8. 8सभी documents upload करें
  9. 9Submit complaint
  10. 10Ombudsman decision wait करें (3 months)

Documents and Proof to Keep Ready

Policy document, proposal form, and premium receipt
Claim form, claim number, and insurer acknowledgement
Rejection letter, settlement offer, or delay communication
Medical bills, discharge summary, repair estimate, or survey report as applicable

Common Mistakes to Avoid

Not reading the rejection reason before drafting the complaint
Missing policy number, claim number, or insurer branch details
Filing with incomplete bills, reports, or claim correspondence

Escalation Path

  1. Stage 1
    Raise a written complaint with insurer grievance cell
  2. Stage 2
    Escalate to insurer grievance officer if unresolved
  3. Stage 3
    Approach IRDAI/Bima Bharosa or Insurance Ombudsman as applicable

Sample Complaint Draft

Subject: Insurance complaint regarding policy {{policy_number}} and claim {{claim_number}}

I hold policy number {{policy_number}} with {{insurer_name}}. I submitted claim number {{claim_number}} for {{claim_reason}} on {{claim_date}}. The claim was rejected/delayed/partly settled citing {{rejection_reason}}. I believe this is incorrect because {{brief_explanation}}. I am attaching policy copy, premium receipts, claim documents, and insurer communication. Please reconsider and settle the claim with written reasons.

Related Keywords

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Related Complaint Templates

Use these samples as a starting point and customize every fact before submission.

Official Complaint Portals

Open the official route in a new tab and keep the acknowledgement number after submission.

National Consumer Helpline (NCH)

Central government portal for consumer complaints across all sectors

Visit PortalPhone: 1800-11-4000

e-Daakhil Consumer Court

Online filing of consumer complaints in consumer courts

Visit PortalPhone: 1800-11-4000

IRDA - Insurance Complaints

Insurance Regulatory and Development Authority for insurance complaints

Visit PortalPhone: 155255

VAHAN 4.0 Citizen Services

Official MoRTH portal for vehicle registration, RC services, and transfer of ownership services

अक्सर पूछे जाने वाले सवाल (FAQ)

Common questions about filing Insurance complaints in India.

Insurance claim reject hone pe kya karein? (बीमा दावा अस्वीकार)
Pehle rejection letter padh kar reason samjhein. Insurer ke Grievance Cell mein written complaint karein additional documents ke saath. 15 din mein resolve na ho toh IRDAI ke Bima Bharosa portal pe complaint file karein ya Insurance Ombudsman approach karein.
Health insurance claim mein delay ho raha hai toh kya karein?
IRDAI guidelines ke anusar cashless claim 2 ghante mein aur reimbursement claim 30 din mein settle hona chahiye. Delay ho toh insurer ko written complaint dein claim number ke saath. Uske baad IRDAI helpline 155255 pe call karein.
IRDAI mein complaint kaise file karein?
IRDAI ke Bima Bharosa portal (bimabharosa.irdai.gov.in) pe online complaint file karein. Policy number, claim number, insurer ka naam, aur complaint details bharen. Alternatively, igms.irda.gov.in portal bhi use kar sakte hain.