Your Health Claim Is Delayed. The Clock Is Already Running.

Most health claim delays are not the insurer's fault on paper. They are the result of repeated document queries, partial responses, and unclear escalation paths. The 2024 IRDAI Master Circular is clear: a reimbursement claim must be settled within 15 days of the last necessary document. Miss that, and interest at bank rate plus 2% runs from the date the insurer was first intimated of the claim — and the insurer must pay it automatically, without you asking.

The catch is that the 30-day clock only starts when documentation is 'complete'. Insurers exploit this by sending small follow-up queries every week. Each query resets the perception of the timeline. By the time you realise, three months have passed.

The right move is to break the loop. Submit every document in a single indexed bundle with a covering letter that lists each item. Ask the insurer for a consolidated query list, not piecemeal questions. If queries keep coming, escalate to the Grievance Redressal Officer with a TAT-violation citation.

BimaHaq drafts the TAT-violation letter, gets you a written acknowledgement of the documentation complete date, and pursues interest where it is due. We also know which TPAs and insurers respond best to which tone — and which need an Ombudsman escalation to wake up.

Pursuing delay is not always glamorous. But it works. We have recovered settlements ranging from ₹40,000 to ₹14 lakh purely on TAT grounds, with interest, after the policyholder had given up.