Claim guide

How to complain about an insurance company

India has a proper complaint ladder. It is free at every step and it works better than calling the helpline again and again. The one rule is to climb it in order.

Why the order matters

Each step exists because the one below it did not work. So each step asks what happened in the step before. If you jump straight to IRDAI with no complaint number from the company, it usually gets sent back to the company, and you lose two weeks.

The ladder

1. The company's customer service Their website, helpline or a branch. Give the claim number and ask for the reason in writing. Many complaints end here, once someone has to write it down.
2. The company's grievance team This is separate from normal customer care, and every company has one. Use their grievance page so you get a complaint number. Keep it. Every later step asks for it.
3. IRDAI, on Bima Bharosa The government's own free complaint website: bimabharosa.irdai.gov.in. You can also track your complaint there, which is why it beats email.
4. The Insurance Ombudsman An independent office that decides insurance fights without court. Free, and no lawyer needed. Addresses are in your policy paper and at cioins.co.in.

What to keep ready

• Your policy number and claim number
• The rejection or deduction letter
• Your complaint number from the company
• Dates: admission, discharge, when you sent the claim, and every reply
• The bill, discharge summary, and the policy pages your case is about
• What you want, in one line: the amount, and why you think it is payable

Write it so it can be acted on

Short and exact works best. Not "my claim was unfair", but "the letter says clause X; clause X does not apply because of Y, and here is the paper that shows it".

Two things to always ask in writing:

• Which clause was used. You have the right to know.
• How the amount was worked out, if money was cut. A cut nobody can explain line by line is worth questioning.

Better still, avoid needing this

Everything here is a cure after something went wrong. Most rejections in India come from paperwork that could have been fixed before sending: a missing receipt, dates that do not match, an unsigned form, a room above the policy limit.