Claim Solution
Complaint to Grievance Redressal Officer (GRO)
In an unfortunate event of Claim Denial/Rejection or Short Settlement/Deductions by the insurance company, follow the steps below:
Send a complaint to the insurance company’s Grievance Redressal Officer via any one of the following means:
Click the link below to Register a complaint on IRDAI’s Bima Bharosa portal
or
Click here to get the contact details of Grievance Redressal Officer of the company & send a direct email.
or
Email to IRDAI at complaints@irdai.gov.in
Note: Complaint filed via any of the above medium will go/forwarded to the Grievance Redressal Officer of the insurance company. Try to attach any new document or proof (if available) to make insurance company Re-consider the claim.
In case if complaint is not resolved within two weeks or if you are not satisfied with the resolution. Then,
Complaint to Insurance Ombudsman
Approach the Insurance Ombudsman within 1 year from the date of rejection of complaint by the insurer or if the insurer fails to reply the complaint for the last one month.
Click the link Below to file an online complaint to Insurance Ombudsman
or
Send a complaint via courier or physically submitting the required documents copy by visiting your State’s Insurance Ombudsman office.
Click here to see the complete list of offices.
To know the details of required documents & other faq’s on filing complaint to Insurance Ombudsman, Click here
It usually takes upto 3 to 6 months for resolution of Complaint in Insurance Ombudsman office. Increased burden may lengthen up the duration.
In case Insurance ombudsman’s award goes in favour of the customer, Insurer has to comply with or pay the awarded amount to the customer within 30 days. In case of a delay, a per day compensation amount to be added by the insurer to the awarded amount.
Note: Insurance ombudsman can only award the Claim amount upto Rs.50 Lacs. No interest or Compensation can be claimed at this stage by the customer.
Complaint to Consumer Court
If not satisfied with the Insurance Ombudsman’s award, Complainant can approach the Consumer court.
A suitable lawyer can send a 15 days Legal Notice to the insurance company at the insurer’s registered address via courier. If Insurer doesn’t agree to settle the claim within these 15 days, hearing proceedings can be started at District consumer court with the help of the lawyer or complainant himself can proceed without any lawyer (if he/she can do so). In case of any assistance, you can contact us
Claim amount with Interest & Compensation can be filed at this stage by the complainant.
Click here to know more about the general claim process in health insurance
Click here to know more about the general claim process in term insurance
