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Insurance claim rejected? The free escalation path, step by step

If your claim is denied or underpaid, you do not have to accept the first 'no'. There is a free, structured escalation path, and most of it never involves a lawyer.

Step 1 — Your insurer's grievance officer

Raise a written grievance with the insurer's Grievance Redressal Officer. For a life-insurance repudiation, ask specifically for a Claims Review Committee (CRC) review. The insurer must acknowledge and respond within about 15 days.

Step 2 — IRDAI Bima Bharosa

If it is unresolved within about 15 days or the reply is unsatisfactory, escalate on IRDAI's official grievance portal, Bima Bharosa (bimabharosa.irdai.gov.in).

Step 3 — The Insurance Ombudsman

The Insurance Ombudsman is free and binding on the insurer, with an award cap of about ₹50 lakh (raised from ₹30 lakh in November 2023). File within 1 year of the insurer's rejection.

Bank-linked covers fork to the RBI

If the failure is a bank-service problem — a premium that was never auto-debited, or a RuPay issue — complain to the bank first and wait up to 30 days, then escalate free to the RBI Integrated Ombudsman: toll-free 14448, file at cms.rbi.org.in.

Source: IRDAI Bima Bharosa; Insurance Ombudsman Rules 2017 (amended Nov 2023); Reserve Bank – Integrated Ombudsman Scheme 2026. General guidance — verify with IRDAI / RBI for your case.

Frequently asked

Do I need a lawyer to escalate a rejected claim?

No. The path — insurer's grievance officer → IRDAI's Bima Bharosa portal → the Insurance Ombudsman — is designed for policyholders themselves, and most of it never involves a lawyer.

How long does the insurer have to respond to my grievance?

About 15 days once you file in writing with the Grievance Redressal Officer. If it stays unresolved or the reply is unsatisfactory, escalate on Bima Bharosa (bimabharosa.irdai.gov.in).

Is the Insurance Ombudsman free, and is its decision binding?

Filing is free, and an award is binding on the insurer, with a cap of about ₹50 lakh (raised from ₹30 lakh in November 2023). File within 1 year of the insurer's rejection.

What if my cover was sold through my bank?

If the insurer rejected the claim itself, use the IRDAI route above. If the bank failed the service — for example the premium was never auto-debited — complain to the bank first, and after 30 days escalate free to the RBI Integrated Ombudsman: toll-free 14448, cms.rbi.org.in.

ClaimSarathi KB — IRDAI Bima Bharosa; Insurance Ombudsman Rules 2017 (award cap raised to ₹50 lakh, Nov 2023 amendment); Reserve Bank – Integrated Ombudsman Scheme 2026 (in force 1 Jul 2026) · As of 2026-07-04