Reviewed on: 2026-06-12.
An insurance claim can fail at three points, and each failure has a different counter-move. It can fail after approval, when the insurer accepts the claim but the money never arrives; the IRDAI policyholder protection regulations of 2024 let you demand interest at bank rate plus 2 percent on that delay. It can fail at the decision, when the claim is closed and nobody tells you; you demand the written closure grounds and push to reopen. And it can fail during processing, when the portal shows a document missing that you uploaded weeks ago; you build an evidence trail and refuse to play the endless deficiency game. This category has a dedicated guide for each of those three failures.
It covers every claim type in one place. Health claims, including the two cashless traps: a denial because the hospital was quietly blacklisted, and a hospital demanding extra payment on top of an approved cashless amount. Property claims, such as a burglary claim closed with no explanation. The escalation ladder is common: the insurer's grievance officer first, then the Bima Bharosa portal of IRDAI, then the insurance ombudsman at cioins.co.in for claims up to Rs 50 lakh. LIC and the public sector general insurers answer RTI directly; private insurers do not, but IRDAI does, and that is often enough.
Other problem areas are on the all practical guides page.