Claim rejected
Insurance claim rejected? Your options, in order.
Last updated 23 October 2026.
The short answer. A rejection is not the end. Write to the insurer, then its grievance officer, then register the complaint on Bima Bharosa, and, if it is still unresolved, take it to the Insurance Ombudsman, which is free for the complainant. Keep every letter and reply; each step builds on the last.
Your options
What to do after a rejection.
Work through these in order. Each step gives you a written record for the next.
- 1. Read the rejection letter. Note the exact reason given and the policy clause it relies on. Ask for the documents the insurer relied on if they were not sent.
- 2. Write to the insurer. Send a written grievance that answers the reason given, point by point. Keep proof that it was received.
- 3. Escalate to the grievance officer. If the reply does not resolve it, write to the insurer’s grievance officer and attach the earlier correspondence.
- Register on Bima Bharosa. This is IRDAI’s online grievance portal. It states that a registered complaint will be attended to within 14 days.
- Approach the Insurance Ombudsman. If the insurer has rejected your complaint, has not replied within a month, or the reply is not acceptable, you can complain to the Insurance Ombudsman within one year. There is no fee, and compensation sought should not exceed ₹50 lakh.
Documents to keep
- The rejection letter and any earlier claim correspondence
- The policy document and schedule
- Claim form and the papers you submitted with it
- Medical or other records the claim relied on
- Every grievance letter you send, with proof of receipt
- The insurer’s replies, including the grievance officer’s
Why claims are rejected
Reasons given, and what to check.
The reason stated in the letter decides what your reply should address. These are the ones we see most.
- Pre-existing disease. Check how the policy defines it and whether the condition was in fact diagnosed or treated before the policy began.
- Non-disclosure. Check what the proposal form asked and what you answered, and whether the point alleged was actually asked.
- Waiting period. Check the waiting period written in your policy and the date the condition arose.
- Documents missing. Check what was asked for and when. Many of these can be cured by sending the paper.
- Policy lapsed. Check premium dates, any grace period and renewal notices received.
How Samadhan Sarathi helps
We prepare it, step by step.
We read the papers against the policy wording, prepare your grievance and escalation letters, and, where it comes to that, prepare the Ombudsman petition. You sign it and return it, and we submit it online. A team of specialists works your file, supported by AI-assisted review of the policy and the correspondence.
Our fee
- 12% of what we recover for you
- GST included
- Nothing payable upfront
Who we are. Samadhan Sarathi is a private service based in Ludhiana. We are not the government, not the insurer, not a bank, and not IRDAI or the Insurance Ombudsman. We prepare your papers and take you through the process.
Questions
Common questions.
My insurance claim was rejected. What are my options?
Write to the insurer, escalate to its grievance officer, register on Bima Bharosa, and then complain to the Insurance Ombudsman if it is still unresolved. The order and the records you keep matter.
What is the grievance officer?
Every insurer has a grievance officer to whom you can escalate when the first reply does not resolve your complaint. Write to them with your earlier letters attached.
What is Bima Bharosa?
Bima Bharosa is IRDAI’s online grievance portal where you can register and track a complaint against an insurer. It does not take any payment.
How long do I have to go to the Insurance Ombudsman?
Within one year of the insurer’s rejection of your complaint, or within one year after a month has passed without a reply.
Does the Insurance Ombudsman charge a fee?
No. The Ombudsman does not charge any fee for grievance redressal.
What is the claim limit for an Ombudsman complaint?
The compensation sought should not exceed ₹50 lakh.
Will Samadhan Sarathi get my claim paid?
We cannot promise any outcome. We prepare your papers and take the case through each step; the decision rests with the insurer or the forum.
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