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Claim rejected by
your insurer?
The same IRDAI rules apply to every health insurer in India, so the route to challenge a rejection is the same. Find your insurer below.
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The route, for every insurer
- Read the reason and the clause. Every rejection or partial payment must come with full details, referring to the specific terms and conditions of your policy. Note the clause number, the exact words of the reason and the date of the letter. If no clause is named, that is a weakness in the decision.
- Check the reason against the rules. A pre-existing disease waiting period is capped at 36 months of continuous cover. After 60 months of continuous cover, a claim can’t be contested for non-disclosure except for established fraud. No claim shall be rejected or closed only for missing documents or late intimation. Room-rent caps, sub-limits and co-payment must be written in your policy.
- Complain to the insurer in writing. Write to the insurer’s Grievance Redressal Officer, whose details are in your policy document, on the insurer’s website and usually in its letters. The insurer must acknowledge immediately and resolve the complaint within 14 days. You can also register it on Bima Bharosa, IRDAI’s grievance portal.
- Go to the Insurance Ombudsman. If the insurer rejects your complaint, doesn’t reply within one month, or you’re not satisfied with the reply, complain to the Insurance Ombudsman. It’s free, it can award up to ₹50 lakh including expenses, and you must file within one year of the insurer’s reply.
Full detail: what to do when a health claim is rejected, the complaint letter format, Bima Bharosa and the Ombudsman guide.
Check my claim, first report freeInsurers
Star Health claim rejected
Star Health and Allied Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance.
To challenge a Star Health decision, write to Star Health’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Star Health branch you dealt with or where you live.
Care Health claim rejected
Care Health Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance. It was earlier called Religare Health Insurance, so older policy papers may carry that name.
To challenge a Care Health decision, write to Care Health’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Care Health branch you dealt with or where you live.
Niva Bupa claim rejected
Niva Bupa Health Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance. It was earlier called Max Bupa Health Insurance, so older policy papers may carry that name.
To challenge a Niva Bupa decision, write to Niva Bupa’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Niva Bupa branch you dealt with or where you live.
Aditya Birla Health claim rejected
Aditya Birla Health Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance.
To challenge a Aditya Birla Health decision, write to Aditya Birla Health’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Aditya Birla Health branch you dealt with or where you live.
HDFC ERGO claim rejected
HDFC ERGO General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a HDFC ERGO decision, write to HDFC ERGO’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the HDFC ERGO branch you dealt with or where you live.
ICICI Lombard claim rejected
ICICI Lombard General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a ICICI Lombard decision, write to ICICI Lombard’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the ICICI Lombard branch you dealt with or where you live.
Tata AIG claim rejected
Tata AIG General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Tata AIG decision, write to Tata AIG’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Tata AIG branch you dealt with or where you live.
Bajaj General claim rejected
Bajaj General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim. It was earlier called Bajaj Allianz General Insurance, so older policy papers may carry that name.
To challenge a Bajaj General decision, write to Bajaj General’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Bajaj General branch you dealt with or where you live.
SBI General claim rejected
SBI General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a SBI General decision, write to SBI General’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the SBI General branch you dealt with or where you live.
ManipalCigna claim rejected
ManipalCigna Health Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance. It was earlier called CignaTTK Health Insurance, so older policy papers may carry that name.
To challenge a ManipalCigna decision, write to ManipalCigna’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the ManipalCigna branch you dealt with or where you live.
Galaxy Health claim rejected
Galaxy Health Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance.
To challenge a Galaxy Health decision, write to Galaxy Health’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Galaxy Health branch you dealt with or where you live.
Narayana Health Insurance claim rejected
Narayana Health Insurance is a standalone health insurer, which means it sells health, personal accident and travel cover rather than motor or property insurance.
To challenge a Narayana Health Insurance decision, write to Narayana Health Insurance’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Narayana Health Insurance branch you dealt with or where you live.
Reliance General claim rejected
Reliance General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Reliance General decision, write to Reliance General’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Reliance General branch you dealt with or where you live.
IFFCO-Tokio claim rejected
IFFCO-Tokio General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a IFFCO-Tokio decision, write to IFFCO-Tokio’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the IFFCO-Tokio branch you dealt with or where you live.
Chola MS claim rejected
Cholamandalam MS General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Chola MS decision, write to Chola MS’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Chola MS branch you dealt with or where you live.
Royal Sundaram claim rejected
Royal Sundaram General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Royal Sundaram decision, write to Royal Sundaram’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Royal Sundaram branch you dealt with or where you live.
Universal Sompo claim rejected
Universal Sompo General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Universal Sompo decision, write to Universal Sompo’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Universal Sompo branch you dealt with or where you live.
Generali Central claim rejected
Generali Central Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim. It was earlier called Future Generali India Insurance, so older policy papers may carry that name.
To challenge a Generali Central decision, write to Generali Central’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Generali Central branch you dealt with or where you live.
Liberty General claim rejected
Liberty General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim. It was earlier called Liberty Videocon General Insurance, so older policy papers may carry that name.
To challenge a Liberty General decision, write to Liberty General’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Liberty General branch you dealt with or where you live.
Zurich Kotak claim rejected
Zurich Kotak General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim. It was earlier called Kotak Mahindra General Insurance, so older policy papers may carry that name.
To challenge a Zurich Kotak decision, write to Zurich Kotak’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Zurich Kotak branch you dealt with or where you live.
Digit Insurance claim rejected
Go Digit General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Digit Insurance decision, write to Digit Insurance’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Digit Insurance branch you dealt with or where you live.
Acko claim rejected
Acko General Insurance is a private general insurer. It sells health insurance alongside motor, home and other cover, so make clear in every letter that your complaint is about a health claim.
To challenge a Acko decision, write to Acko’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Acko branch you dealt with or where you live.
New India Assurance claim rejected
The New India Assurance Company is a public sector general insurer, owned by the Government of India. It sells health insurance alongside motor, home and other cover.
To challenge a New India Assurance decision, write to New India Assurance’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the New India Assurance branch you dealt with or where you live.
United India claim rejected
United India Insurance Company is a public sector general insurer, owned by the Government of India. It sells health insurance alongside motor, home and other cover.
To challenge a United India decision, write to United India’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the United India branch you dealt with or where you live.
Oriental Insurance claim rejected
The Oriental Insurance Company is a public sector general insurer, owned by the Government of India. It sells health insurance alongside motor, home and other cover.
To challenge a Oriental Insurance decision, write to Oriental Insurance’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the Oriental Insurance branch you dealt with or where you live.
National Insurance claim rejected
National Insurance Company is a public sector general insurer, owned by the Government of India. It sells health insurance alongside motor, home and other cover.
To challenge a National Insurance decision, write to National Insurance’s Grievance Redressal Officer, then go to the Insurance Ombudsman covering the National Insurance branch you dealt with or where you live.
Insurer not listed? The route above is the same.
Questions people ask
Do the same rules apply to every insurer?
Yes. IRDAI’s rules on claims, complaints and the Ombudsman apply to every health insurer in India, whether it is a standalone health insurer, a private general insurer or a public sector insurer.
How long does an insurer have to reply to my complaint?
It must acknowledge the complaint immediately and resolve it within 14 days.
My letter came from a TPA. Who do I complain to?
The insurer. A third party administrator processes claims for the insurer, but the complaint goes to the insurer’s Grievance Redressal Officer.
Which Ombudsman office handles my complaint?
The office covering the insurer’s branch or office you dealt with, or the office for the place where you live.
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