Insurance claim rejected

What you need to know

Insurance claim can only be rejected for valid documented reasons stated in the policy. Unreasonable rejection is deficiency in service. File with Insurance Ombudsman — free of cost, faster than Consumer Forum.

Your rights

Written reason for claim rejection

Grievance redressal with insurer first

Insurance Ombudsman complaint — free and faster

Consumer Forum complaint

IRDAI complaint for systemic violations

What you should do now

Action first

Write formal complaint to insurer's grievance officer

Send written complaint explaining why rejection is incorrect
Attach all supporting documents: medical records, policy, claim form

Approach Insurance Ombudsman

File at cioins.co.in — free, binding, covers claims up to ₹30 lakh
Faster than Consumer Forum and specifically designed for insurance disputes

If Ombudsman ruling is also unfavorable

File Consumer Forum complaint
Or IRDAI complaint at bimabharosa.irdai.gov.in

Acts applicable

Insurance Act 1938

central

Policy terms and claim settlement obligation

IRDAI Regulations

central

Protection of Policyholders Interests Regulations

Where to complain

IRDAI Bima Bharosa Portal Insurance Ombudsman Consumer Complaint — e-Jagriti Portal

Consumer complaint portal: e-jagriti.gov.in (replaced edaakhil.nic.in as of Jan 2025). Labour complaints: col.gujarat.gov.in. All links verified June 2026 via web search against official government sources.