If your insurance claim was rejected, delayed, or short-paid in India, there is a defined escalation ladder. Work through it in order — each rung builds the paper trail the next one needs.
Step 1 — Get the rejection in writing
Before anything else, ask the insurer or TPA for the written repudiation (denial) letter that cites the exact policy clause and reason, plus a copy of your policy wording and the claim file. You cannot effectively challenge a rejection you cannot see. This letter is the backbone of every later step.
Step 2 — Insurer's Grievance Redressal Officer (GRO)
Every insurer has a Grievance Redressal Officer. File a dated written grievance (email is fine), attaching the rejection letter and your reasons, and get a complaint reference number. The insurer must acknowledge the grievance immediately and provide a resolution within 14 days of receipt, with reasons referenced to your policy's terms (IRDAI Master Circular on Protection of Policyholders' Interests, 2024). If it is not resolved within 30 days, or the decision is unacceptable, you may approach the Insurance Ombudsman.
Step 3 — IRDAI via the Bima Bharosa portal
If the insurer does not resolve the grievance within 14 days, or the reply is unsatisfactory, escalate to IRDAI through the Bima Bharosa grievance portal (bimabharosa.irdai.gov.in, formerly IGMS). IRDAI takes it up with the insurer and tracks resolution. This is a regulator-backed nudge, not an adjudication, but it often unlocks a stuck claim.
Step 4 — Insurance Ombudsman
You can approach the Insurance Ombudsman once the insurer rejects the grievance, fails to reply within one month, or the reply is unsatisfactory — and you must do so within one year of that. It is free, and the award is binding on the insurer. Monetary complaints are entertained up to ₹50 lakh. There are 17 Ombudsman offices across India; you file with the one for your jurisdiction, in writing or online at cioins.co.in. Important: come to the Ombudsman BEFORE any consumer forum or court case — under Rule 14(5) of the Insurance Ombudsman Rules, 2017, a complaint is not maintainable if the same subject matter is pending before, or was already decided by, a court, consumer forum, or arbitrator.
Step 5 — Consumer Commission (e-Jagriti) or mediation
Wrongful claim rejection is a "deficiency in service." As an alternative, or if the dispute is beyond the Ombudsman's limit, you can file a consumer complaint online via e-Jagriti (e-jagriti.gov.in) — the National Informatics Centre portal that replaced e-Daakhil on 1 January 2025 — with the District, State, or National Consumer Commission, or resolve the dispute through mediation under the Mediation Act, 2023. Choose based on the amount, urgency, and evidence. Note: filing here permanently closes the Insurance Ombudsman route for the same dispute (Rule 14(5)) — if you want the free, binding Ombudsman award, use it first.
Source: IRDAI Master Circular on Protection of Policyholders' Interests, 2024; Insurance Ombudsman Rules, 2017 (as amended 2023). Last reviewed 2026-07-05.