What to do if your insurance claim is denied by the provider?

Nov 19, 2021 1 min read
What to do if your insurance claim is denied by the provider?

It can be very heartbreaking to have an insurance claim rejected. It hurts financially and mentally. If your insurer has denied your claim, there can be a legitimate reason for it. However, that's not the end of your case. If you have reviewed your policy and genuinely feel that you have been treated unjustly, then you can raise complaints.

There are several steps which you can follow. Let's take a closer look.

Approach the grievance officer

The first step is to reach the grievance officer of the insurance company to know the reasons why the claim was rejected. The policyholder can raise complaint in writing with necessary documents and evidences which includes eyewitness, photographs, medical reports, police reports, etc. Make copies of everything to give to the insurance company so that you can keep the originals.

Contact IRDAI

Policyholder can approach the Insurance Regulatory and Development Authority of India (IRDAI), if not satisfied with the answer of the grievance officer and also take up the complaint with the IRDAI Grievance Call Centre. Also, the policyholder can file a complaint with IRDAI's website where one can monitor the status of the complaint.

Reach to insurance ombudsman

Last but not the least, one can go to Insurance Ombudsman, according to IRDAI's consumer education website, policyholders to have their complaints settled out of the court system in an efficient, effective and impartial way. At present, there are 17 insurance ombudsman at different locations, to make a complaint in writing, duly signed by the complainant with name and address, name of the branch of the insurance company, and facts giving rise to the complaint with supported documents.

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