Overview
Wrongful rejection or unreasonable delay of a valid insurance claim is a deficiency in service under the Consumer Protection Act, 2019. Policyholders can also approach the Insurance Ombudsman (IRDAI) for disputes up to ₹50 lakh.
Key Provisions — Consumer Protection Act, 2019
- Unfair claim rejection is treated as deficiency in service.
- The Insurance Ombudsman handles claims up to ₹50 lakh free of cost.
- Insurers must follow IRDAI regulations on claim settlement timelines.
- Consumer Commissions can award the claim amount plus compensation.
What You Can Claim
Settlement of the rejected claim
Interest for delayed settlement
Compensation for harassment
Refund of premium where applicable
How We Solve It
1
Analyse Rejection
We review the policy, rejection letter, and grounds.
2
Represent to Insurer
Formal representation / Ombudsman complaint.
3
File Consumer Case
If unresolved, a complaint before the Consumer Commission.
4
Recover Claim
We pursue the claim amount and compensation.
Typical timeline: Ombudsman: ~3 months · Consumer Commission: 3–12 months.
Frequently Asked Questions
Can I challenge a rejected insurance claim?
Yes, through the Insurance Ombudsman or a consumer complaint for deficiency in service.
Is there a free option to dispute insurance claims?
Yes, the Insurance Ombudsman handles claims up to ₹50 lakh at no cost.