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Exit Guide

What to do if you have an issue with the claim settlement?

The insurance company must settle your claim within 30 days from when you submit all the documents.

The company can take a maximum of 90 days in some cases where there is a delay.

Read on to find an answer!

Follow up through these steps:

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    Write a complaint letter to the manager of your Insurance company. You can either hand over the letter by visiting the branch office or send it through post.

This is a model letter that you can use.

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    What to do if even after giving the complaint letter the insurance company does not address your issue?

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    Go to an Insurance Ombudsman: 

    An Insurance Ombudsman is a third party who can help solve your issues. Go to them after 60 days of submitting your Claim Intimation.

Contact details for some Insurance Ombudsmen can be found in this link. Find one in your area. If your issue is not resolved at the Ombudsman stage, you can contact the IRDAI.

 

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    Register a complaint with the IRDAI. You can do this in two ways.

  • Call on their toll free number: 155255 (or) 1800 4254 732
  • Register complaint on CPGRAMS portal
  1. Sign up on CPGRAM portal as a new user.
  2. You will receive a link on your email.
  3. Open the link and you will be redirected to your account.
  4. Lodge a complaint related to Insurance and track the status of action taken on complaint via this portal.

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    You can write to the IRDAI in two more ways:

  1. Send an email to [email protected] . In the email, include: 
  1. Policy Number
  2. Name of Insured
  3. Details of the claim (Date of death, place, etc)
  4. Mention what your issue with the Insurance Company is
  5. Name and Identity Proof of the person making the claim
  6. Scanned copy of the filled Complaint Registration form.

2. Instead of an email, you can send a grievance letter with the same information to the General Manager of IRDAI. Send it to this address:

This is a model grievance letter. Fill in your details:

Along with the letter, fill and send complaint registration form.

Quick Tip

You can track your complaint through IRDAI’s Integrated Grievance Management System

If all the above options fail to solve your issue, there is one more option you can use.

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    File a legal complaint against your Insurance company: 

    If the insurance company does not abide by the claim settlement rules, you can file a legal complaint against the company. 

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    Points to remember

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    The insurance company must settle your claim within 30 days. There can be a delay of a maximum of 90 days.

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    If the company takes longer than this to settle your claim or if you are not satisfied with how much money they pay, you can take some actions.

     

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    Follow the steps in this chapter to address your issues with claim settlement.

     

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