ClaimRejectedMy reports

Features

Everything in
your claim report.

Six parts, built from your own documents and IRDAI’s current rules. Every fact shows where it came from, and every point cites the rule behind it.

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A sample report on a fictional knee-replacement claim rejected for a “waiting period”.

Open sample report (PDF)
01

What your documents establish

Every fact is copied from your own papers, with the words it came from.

  • Policy start date and continuous cover, including porting and renewals
  • Hospital, admission dates and diagnosis
  • Amount claimed, amount paid, sum insured
  • The insurer’s decision and its exact words
  • The policy clause the insurer cites
  • Each fact checked word for word against the transcript
02

What the rules say

The rules that apply to the insurer’s reason, in plain English, with rule numbers you can quote.

  • 60-month moratorium and ported cover
  • Pre-existing disease definition and the 36-month cap
  • Waiting periods and the accident exception
  • Non-disclosure limited to what the proposal form asked
  • Claims can’t be rejected for missing documents or late intimation
  • Repudiation must cite the exact policy clause
03

Where the insurer may be wrong

Each point ties a rule to your facts, ready to paste into a complaint.

  • The insurer’s proof that is missing from the papers
  • Waiting periods that have already run out
  • Exclusions the records don’t support
  • Deductions applied too widely or without a basis
  • Procedural failures, like no clause cited
  • Marked as coming from your documents or from your answers
04

What we still don’t know

Yes/no questions for facts that papers rarely show. Your answers update the report instantly.

  • Did the proposal form ask about this condition?
  • Was this caused by an accident?
  • Counting ported cover, had the waiting period ended?
  • Did your doctor say treatment was medically necessary?
  • Which missing document would change the answer
05

What to do next

The route that works, with every deadline.

  • Who to write to at the insurer, and what to attach
  • The 14-day reply deadline
  • When and how to go to the Insurance Ombudsman (free; it can award up to ₹50 lakh)
  • The 1-year limit to file
  • Bima Bharosa and the consumer commission as alternatives
PDF

Yours to keep

A clean PDF of the whole report to send or print.

  • Send it to the insurer’s grievance officer
  • Share it with family or a lawyer
  • Includes your answers and the date
  • Opens on any phone

We’re on your side
of the claim.

Insurers have claim teams. Now you have the rules, the facts and the next step, in about a minute.

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