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Reimbursement Claim not Processed: What to Do Next
RBI Ombudsman as of 1 July 2026: Bank, certain NBFC, prepaid-instrument and credit-information complaints go under the Reserve Bank - Integrated Ombudsman Scheme, 2026, which replaced RB-IOS 2021 from 1 July 2026. First complain to the entity. If there is no reply in 30 days (or the longer NPCI/card-network window, if it applies) or you reject the reply, file free at cms.rbi.org.in within 90 days. The Ombudsman can award up to Rs 30 lakh for consequential loss and up to Rs 3 lakh for time, expenses and harassment. Complaints received before 1 July 2026 stay under the 2021 scheme. Source: RBI FAQ, updated 1 July 2026 and the RB-IOS 2026 FAQ PDF dated 1 July 2026.
Quick Reply: India guide for reimbursement claim not processed: 30-second answer, documents, escalation matrix, complaint template, RTI use, official sources and next action checklist.
Reviewed on: 2026-05-30.
30-Second Answer
If reimbursement claim not processed, collect the account, application, transaction, policy, property, employee, pension, scholarship or bill reference and send one precise written complaint to the office that can correct the record or release the money. Ask for a written reason if the request is refused or kept pending. Escalate with the same evidence bundle to insurer branch, grievance officer, Bima Bharosa and Insurance Ombudsman. Use RTI only for records held by a public authority: file movement, deficiency notes, dispatch records, sanction details, payment advice, inspection reports or reasons recorded on file.
Where to escalate
Use the correct external forum. Use Bima Bharosa or the other official source linked below where it fits the subject. For consumer-service disputes, consider National Consumer Helpline and e-Daakhil. For public departments, CPGRAMS, state grievance portals and RTI may help. For high-value or time-sensitive cases, take professional advice before limitation expires.
Official Sources
What should I do first if reimbursement claim not processed?
Preserve proof, write a dated complaint with reference numbers, and ask for a written decision or correction instead of relying on calls.
Related Guides
Reimbursement claim not processed: How to escalate and recover medical/expense reimbursement?
When your reimbursement claim (medical, travel, or expense) is not processed by your employer or insurer, here is the complete guide:
- Step 1: Types of reimbursement claims. (a) medical reimbursement (employer-provided health benefit), (b) travel reimbursement (official duty travel), © LTA (Leave Travel Allowance) reimbursement, (d) insurance reimbursement (TPA/insurer processing), (e) CGHS/ESIS reimbursement (government health schemes), (f) fuel/vehicle reimbursement.
- Step 2: Common reasons for non-processing. (a) incomplete documentation — missing bills, prescriptions, or reports, (b) bills older than the submission deadline (typically 30-90 days), © the claim exceeds the policy limit or cap, (d) pre-approval was not obtained (for cashless or planned procedures), (e) the TPA or insurer disputes the medical necessity, (f) employer's HR/finance department delays processing.
- Step 3: Employer reimbursement — how to escalate. (a) submit the claim with all supporting documents and get acknowledgement, (b) follow up in writing after 15 days, © if not processed within 30 days: escalate to the HR head or finance head, (d) if still not processed: file a complaint with the Labour Commissioner (for employees covered under the Shops and Establishments Act or Factories Act), (e) for government employees: file a departmental grievance.
- Step 4: Insurance/TPA reimbursement — how to escalate. (a) the insurer must process the claim within 30 days of receiving all documents (IRDAI rule), (b) if not processed: file a complaint with the insurer's grievance officer, © the grievance officer must respond within 15 days, (d) if not resolved: file with IRDAI Ombudsman (bima-sevak.in or cms.rbi.org.in), (e) the Ombudsman can award up to Rs 20 lakh.
- Step 5: CGHS/ESIS reimbursement. (a) for CGHS: file the reimbursement claim at the CGHS wellness center with original bills, (b) CGHS must process within 30 days, © if delayed: file a grievance at cghs.gov.in, (d) for ESIS: file at the ESIS dispensary, (e) if delayed: approach the ESIS Commissioner.
- Step 6: Tax implications. (a) medical reimbursement up to Rs 15,000 is tax-exempt (under the old regime), (b) LTA is tax-exempt for two journeys in a block of four years, © if the reimbursement is delayed and received in a different financial year: it is taxed in the year of receipt, (d) keep all bills and the employer's reimbursement letter for tax filing.
- Step 7: File RTI. File RTI (for government employees or public sector) asking for: (a) the status of your reimbursement claim, (b) the reason for delay, © the time limit for processing reimbursement claims, (d) the number of pending reimbursement claims.