How do I file a complaint against rejection of insurance claim?

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1 min read 18 Sep 2023, 10:32 PM IST Nidhi Verma

Since, the magnitude of assertion is lone ₹2 lakh, you tin record a ailment with the territory user disputes redressal forum.

You tin  record  a ailment  with the user  Court (iStockphoto)Premium You tin record a ailment with the user Court (iStockphoto)

I bought my wellness security argumentation successful 2016 for myself and my wife. I renewed the argumentation each twelvemonth by paying timely premiums till past year. In December 2022, I suffered from typhoid and was admitted successful infirmary for 7 days. The attraction outgo maine astir 2 lakh. My insurer denied the assertion saying that my information did not necessitate hospitalization. What tin I bash to get my assertion from the security company?

-Name withheld connected request

Since you are not satisfied with the effect fixed by your insurer, you person aggregate options to record a complaint.

You tin straight registry your grievance connected the Insurance Regulatory and Development Authority of India’s (IRDAI) online portal, known arsenic the ‘Bima Bharosa System’. You tin take to taxable your ailment via email to [email protected], oregon you tin avail of the toll-free helpline astatine 155255 oregon 1800 4254 732.

You tin lodge a ailment to the Insurance Ombudsman wrong 1 twelvemonth from the day of rejection by the security company.

Since the incidental happened successful December 2022, you inactive person time. You tin record your ailment online connected https://www.cioins.co.in oregon you tin sojourn your nearest ombudsman bureau and record an offline complaint.

Alternatively, you tin record a ailment with the user Court. Since, the magnitude of assertion is lone 2 lakh, you tin record a ailment with the territory user disputes redressal forum.

You tin either record the ailment online oregon you tin besides constitute the complaint, connect each applicable documents and registry it offline. You volition besides person to record an affidavit successful the tribunal stating that each the facts and statements presented by you are existent and correct. The user forum whitethorn complaint you a interest ranging from 100 to 5,000.

In a akin case, the Surat District Consumer Redressal Commission issued a directive to an security institution past month. The committee ruled that the determination regarding the request for hospitalization should beryllium entrusted to aesculapian professionals’ discretion alternatively than being solely determined by the security company.

Nidhi Verma is laminitis and main enforcement serviceman astatine Algates Insurance

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Updated: 18 Sep 2023, 10:32 PM IST

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