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—practical-guides:health-insurance-cashless-approval-delay-tpa-hospital [2026/07/22 17:47] (current) – created - external edit 127.0.0.1
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 +{{htmlmetatags>metatag-canonical=(https://righttoinformation.wiki/cashless-health-insurance-denied-hospital-india)&metatag-title=(Cashless Approval Delayed by TPA or Hospital? Do This)&metatag-description=(Cashless approval delayed by your TPA or hospital? Step-by-step escalation: hospital desk script, TPA email, insurer grievance and IRDAI complaint route.)&metatag-keywords=(Insurance, approval, cashless, delay, health, hospital, insurance)&metatag-robots=(index,follow)&metatag-og:title=(Cashless Approval Delayed by TPA or Hospital? Do This)&metatag-og:description=(Cashless approval delayed by your TPA or hospital? Step-by-step escalation: hospital desk script, TPA email, insurer grievance and IRDAI complaint route.)&metatag-og:type=(article)}}
 +
 +====== Cashless Health Insurance Approval Delayed by TPA or Hospital? Do This ======
 +
 +**When the TPA goes silent or the hospital insurance desk shrugs, you do not have to sit and wait. This guide gives you the exact words to use at the hospital, an email template for the insurer, and the full escalation ladder — from the Grievance Redressal Officer up to IRDAI's Bima Bharosa and the Insurance Ombudsman.**
 +
 +{{:practical-guides:health-insurance-cashless-approval-delay-tpa-hospital.webp|Cashless Health Insurance Approval Delayed by TPA or Hospital? Do This}}
 +
 +**Reviewed on:** 2026-05-29.
 +
 +<WRAP center round info 95%>
 +**Quick Reply:**
 +
 +Under IRDAI's Master Circular on Health Insurance Business (effective 31 July 2024), your insurer must issue **pre-authorisation within one hour** of the hospital's request and **final discharge authorisation within three hours**. If the deadline is missed, extra hospital charges caused by the delay fall on the insurer. If you are stuck, call the TPA helpline and your insurer's toll-free number right now, log a complaint with the Grievance Redressal Officer in writing, and be ready to escalate to [[/bima-bharosa-health-insurance-complaint-guide|IRDAI's Bima Bharosa]] if the insurer does not act within its own turnaround time.
 +</WRAP>
 +
 +===== Who this guide is for =====
 +
 +This guide is for anyone who is currently admitted to a network hospital — or is preparing to be admitted — and whose cashless health insurance approval has been delayed, queried, or simply ignored by the TPA or insurer. It is also useful for family members managing the paperwork on behalf of a patient.
 +
 +You will find this guide particularly useful if:
 +
 +  * The hospital's insurance desk tells you the TPA has not responded to the pre-authorisation request.
 +  * The TPA has asked for documents and the hospital says it has already sent them.
 +  * Discharge is being held up because the final authorisation amount has not arrived.
 +  * You were admitted as an emergency and are now being asked to pay out of pocket because the cashless process was not initiated in time.
 +  * You have already been discharged after paying the bill yourself, and now want to claim reimbursement — but are worried about missing the deadline.
 +
 +This guide covers policies from both **private health insurers** (such as Star Health, HDFC ERGO, ICICI Lombard, Niva Bupa, Care Health, and others) and **public-sector general insurers** (New India Assurance, National Insurance, Oriental Insurance, United India Insurance). The escalation process is the same for both; the RTI angle differs — see the [[#rti-angle|RTI section below]].
 +
 +For a deeper guide on what to do when cashless is outright denied, read our companion article on [[/cashless-health-insurance-denied-hospital-india|cashless claim denial at the hospital]].
 +
 +===== What you can do this weekend =====
 +
 +==== Friday evening ====
 +
 +If you or a family member is in hospital and cashless approval has stalled, do these things before the day ends:
 +
 +  * Ask the hospital insurance desk for a **written note** (even a WhatsApp message) confirming the date and time the pre-authorisation request was sent to the TPA, and what — if anything — is still pending from the hospital's side.
 +  * Locate your health card or policy document. Write down: your policy number, the TPA name, the TPA helpline number, and your insurer's toll-free customer care number.
 +  * Call the TPA helpline and note the reference number of your complaint call. Ask them to send you a written update — SMS, email, or a message on the insurer's app.
 +  * If the TPA helpline is unreachable after hours, call your insurer's 24-hour emergency helpline. Many insurers have a separate number for hospital emergencies — check your policy schedule or the insurer's website.
 +
 +==== Saturday ====
 +
 +  * If you have not received a written response from the TPA or insurer, send a short email to the insurer's Grievance Redressal Officer. Use the template in the [[#complaint-template|complaint template section]] below. The GRO email address is on your policy document; if not, it is on the insurer's website under "Grievance" or "Customer Service".
 +  * Ask the hospital to share a copy of every query it received from the TPA, and its replies. Keep these safe — you will need them if you escalate.
 +  * If the hospital is holding you back at discharge because the final authorisation amount has not come and you are able to pay, consider paying the bill yourself and switching to a reimbursement claim. Collect **every original document** before you leave. Most policies require reimbursement documents within 30 days of discharge — confirm the exact period in your policy.
 +
 +==== Sunday ====
 +
 +  * If the insurer has not resolved the issue and you are still in hospital, register a complaint on [[https://bimabharosa.irdai.gov.in|IRDAI's Bima Bharosa portal]]. The portal works seven days a week. Upload your complaint, the GRO email you sent, and any correspondence.
 +  * Call IRDAI's toll-free Grievance Call Centre on **155255** (or 1800-4254-732), available 8 AM to 8 PM Monday to Saturday. They can flag your complaint directly to the insurer.
 +  * If discharge is genuinely being blocked and you face a medical or financial emergency, speak to the hospital's patient relations manager or medical superintendent — not just the insurance desk staff — and ask them to escalate internally as well.
 +
 +===== Documents and evidence checklist =====
 +
 +Collect and organise these before or during discharge. Taking clear photographs on your phone is enough if you cannot get photocopies immediately.
 +
 +^ Document ^ Why you need it ^ When to collect ^
 +| Health insurance card / TPA card | Identifies your policy and TPA at the hospital desk | Bring at admission |
 +| Policy document / schedule | Shows sum insured, network details, GRO contact, claim deadlines | Bring at admission |
 +| Pre-authorisation request copy (sent by hospital to TPA) | Proves when the request was made — critical for delay complaints | Ask hospital desk on Day 1 |
 +| TPA query letters / emails + hospital replies | Documents any back-and-forth that caused the hold-up | Collect during stay |
 +| Pre-authorisation approval letter (if issued) | Shows approved amount and scope — used against shortfall disputes | Before discharge |
 +| Discharge summary (signed by treating doctor) | Medical evidence of treatment; required for all claim types | At discharge |
 +| Itemised final hospital bill | Shows breakdown of charges; needed for reimbursement or shortfall claim | At discharge |
 +| All investigation and lab reports | Support medical necessity; insurer may ask for these | At discharge |
 +| All prescriptions from treating doctor | Validates prescribed medicines and procedures | During stay / at discharge |
 +| Payment receipts (if you paid out of pocket) | Required for reimbursement claim | At payment |
 +| Cancelled cheque / bank account details | For reimbursement NEFT transfer | With claim form |
 +| Government photo ID (Aadhaar / PAN / Voter ID) | Identity proof required on the claim form | Bring at admission |
 +| All insurer / TPA correspondence (emails, SMS, app messages) | Evidence trail for escalation and complaints | Throughout |
 +
 +===== Step-by-step action plan =====
 +
 +==== Step 1 — Understand exactly what is blocking the approval ====
 +
 +Before making any calls, go to the [[/practical-guides/insurance-desk-not-processing-claim|hospital's insurance or TPA help desk]] and ask one direct question: //"What is the exact reason the pre-authorisation has not been issued, and whose court is it in right now — ours or the TPA's?"//
 +
 +The delay usually falls into one of three categories:
 +
 +  * **The hospital has not yet sent the complete pre-authorisation request.** In this case, push the hospital desk — not the TPA — to send it immediately with all required documents.
 +  * **The TPA has raised a medical query and the hospital has not yet replied.** Ask the hospital to reply urgently and give you a copy of their response.
 +  * **The TPA or insurer has received the complete request but has not responded.** This is the scenario covered by the IRDAI one-hour rule. Move to Step 2 immediately.
 +
 +==== Step 2 — Call the TPA directly (emergency desk script) ====
 +
 +Most TPAs have a 24-hour helpline for hospitals and policyholders. The number is printed on your health card. When you call, say something like this:
 +
 +"My name is [your name]. My policy number is [number] with [insurer name]. I am a patient admitted at [hospital name] since [date]. The hospital submitted the pre-authorisation request on [date and time, if known] — reference number [if available]. It has now been more than [X hours]. Under IRDAI's current rules, you are required to issue pre-authorisation within one hour of receiving a complete request. Please tell me the current status and when I will get written authorisation. I am logging this call — please give me your name and employee ID."
 +
 +Write down: the TPA agent's name, your call reference number, and the time of the call. Ask them to send a written update to the hospital desk or to your registered mobile / email.
 +
 +==== Step 3 — Call your insurer's toll-free number ====
 +
 +Simultaneously (or right after), call your insurer's toll-free customer care number — printed on your health card, policy document, or the insurer's website. Log a verbal complaint about the delay. The insurer owns the TPA relationship and can instruct the TPA to act. Ask the agent to raise a formal complaint ticket and give you the ticket number.
 +
 +==== Step 4 — Submit a written complaint to the Grievance Redressal Officer ====
 +
 +Every insurer must have a Grievance Redressal Officer (GRO) and publish that person's name, email, and phone number on the policy document and on the insurer's website. Send an email to the GRO with:
 +
 +  * Your policy number, claim reference, and hospital details.
 +  * The timeline — when you were admitted, when the hospital sent the pre-authorisation request, what the TPA has said so far.
 +  * A clear ask: issue the pre-authorisation or the discharge authorisation within 24 hours, or explain in writing why the request is being held.
 +  * All supporting documents attached (pre-auth request copy, hospital correspondence with TPA).
 +
 +Use the [[#complaint-template|TPA email template below]] as a starting point. The insurer is required to acknowledge your complaint and work toward resolution — check your policy or the insurer's website for their stated grievance turnaround.
 +
 +==== Step 5 — Decide whether to switch to reimbursement ====
 +
 +If the delay is causing hardship — if you are stuck at discharge, or if the treatment is urgent and cannot wait — consider paying the hospital bill yourself and filing a reimbursement claim. This is always your right, even on a network hospital cashless policy. Collect every original document before you leave, and submit the claim well within the deadline in your policy (typically 30 days from discharge, but confirm in your own policy schedule). For more on what to do when the cashless route fails entirely, see our guide on [[/cashless-health-insurance-denied-hospital-india|cashless claim denial at hospital]].
 +
 +==== Step 6 — File on IRDAI Bima Bharosa ====
 +
 +If the insurer [[/practical-guides/insurance-company-closes-grievance-prematurely|does not resolve your complaint]] within its own stated timeframe, register a grievance on the [[https://bimabharosa.irdai.gov.in|IRDAI Bima Bharosa portal]]. The process takes about 10 minutes. You will need your policy number, insurer name, and a description of the complaint. Upload your documents and GRO correspondence. IRDAI requires insurers to resolve Bima Bharosa complaints within 14 days. You can track your complaint status on the same portal.
 +
 +You can also call IRDAI's Grievance Call Centre on **155255** or email **[email protected]** to register your grievance by phone or email if you cannot access the portal.
 +
 +==== Step 7 — Insurance Ombudsman or Consumer Forum ====
 +
 +If Bima Bharosa does not produce a resolution, your next option is the Insurance Ombudsman. There are offices in 17 cities across India. The process is free, you do not need a lawyer, and the ombudsman can issue a binding award. See our full guide on [[/insurance-ombudsman-health-insurance-complaint-format|how to complain to the Insurance Ombudsman]]. For large-value or systemic matters, you may also approach a [[/consumer-court-health-insurance-company-complaint|Consumer Disputes Redressal Forum]].
 +
 +===== Escalation ladder =====
 +
 +^ Step ^ Who to contact ^ How ^ Expected turnaround ^ Move to next step if… ^
 +| 1 | Hospital insurance desk | In person; ask for written status | Immediate | Desk confirms TPA has not responded |
 +| 2 | TPA helpline (direct) | Call; ask for written update; log call reference | Within the hour (IRDAI rule) | No written approval within a few hours |
 +| 3 | Insurer toll-free / customer care | Call; request a complaint ticket number | Same day | No resolution by end of next working day |
 +| 4 | Insurer Grievance Redressal Officer (GRO) | Email with documents; request acknowledgment | Acknowledgment within 3 working days; resolution within 2 weeks | No resolution within 2 weeks or unsatisfactory reply |
 +| 5 | IRDAI Bima Bharosa portal | Online at bimabharosa.irdai.gov.in; or call 155255; or email [email protected] | Insurer must resolve within 14 days of IRDAI registration | No resolution or unsatisfactory response |
 +| 6a | Insurance Ombudsman | Online or offline; free; no lawyer needed; check your regional office | Recommendation within 1 month; award within 3 months | Claim value exceeds ombudsman limit or you want a court record |
 +| 6b | Consumer Disputes Redressal Forum | District / State / National forum depending on claim value | Varies | — |
 +
 +===== Copy-paste complaint template =====
 +
 +Replace the text in square brackets with your own details before sending.
 +
 +Subject: Urgent — Cashless Pre-Authorisation Delay — Policy No. [YOUR POLICY NUMBER] — Claim Ref. [CLAIM REFERENCE IF KNOWN]
 +
 +To,
 +The Grievance Redressal Officer,
 +[Insurer Name]
 +[GRO Email Address from your policy document or insurer website]
 +
 +Date: [Date]
 +
 +Dear Sir / Madam,
 +
 +I am writing to register a formal grievance regarding an unacceptable delay in cashless pre-authorisation for my health insurance policy.
 +
 +POLICYHOLDER DETAILS
 +Name: [Your full name]
 +Policy Number: [Policy number]
 +TPA Name: [TPA name, e.g. Medi Assist / HealthIndia / MD India]
 +Insured Patient Name: [Patient's name if different]
 +Hospital Name: [Name and city]
 +Date of Admission: [Date]
 +Nature of Treatment / Diagnosis: [Brief description, e.g. "elective knee replacement" or "emergency appendicitis"]
 +
 +TIMELINE OF EVENTS
 +[Date, Time] — Patient admitted to hospital.
 +[Date, Time] — Hospital's insurance desk confirms pre-authorisation request was submitted to TPA.
 +[Date, Time] — [Describe any queries raised by TPA and responses sent by hospital, if applicable.]
 +[Date, Time] — As of writing, no written authorisation has been received. The delay now stands at [X hours / X days].
 +
 +IRDAI'S MANDATORY TIMELINE
 +Under the IRDAI Master Circular on Health Insurance Business (effective 31 July 2024), your company is required to issue cashless pre-authorisation within one hour of receiving a complete request from a network hospital, and final discharge authorisation within three hours. The delay in my case far exceeds these limits.
 +
 +IMPACT
 +[Describe impact: e.g. "Patient discharge is being held up and additional per-day hospital charges are accruing. The patient's treatment cannot proceed until authorisation is confirmed." Or: "I was forced to pay the hospital bill out of pocket to enable discharge, and am now filing for reimbursement."]
 +
 +RELIEF REQUESTED
 +1. Immediate written authorisation for cashless treatment up to the sum insured under the policy, OR a written explanation of any specific reason for the hold-up.
 +2. If authorisation is not possible, written confirmation that all additional hospital charges caused by this delay will be borne by the insurer as required by IRDAI rules.
 +3. If I have already paid out of pocket, prompt processing of my reimbursement claim within the statutory timeline, with interest for any delay beyond the required period.
 +
 +DOCUMENTS ENCLOSED
 +- Copy of pre-authorisation request submitted by hospital [attach if available]
 +- Copy of TPA correspondence [attach]
 +- Copy of hospital bill / interim bill [attach if available]
 +- Copy of policy schedule / health card
 +
 +I request a written response within 5 working days. If I do not receive a satisfactory reply, I will escalate this matter to IRDAI's Bima Bharosa portal and, if necessary, to the Insurance Ombudsman.
 +
 +Yours sincerely,
 +[Your full name]
 +[Mobile number]
 +[Email address]
 +[Postal address]
 +
 +===== When RTI can help =====
 +
 +The Right to Information Act, 2005 applies to **public authorities**. In the context of health insurance cashless delays, RTI can help in the following situations:
 +
 +==== If your insurer is a public-sector general insurer ====
 +
 +The four public-sector general insurers — **New India Assurance, National Insurance Company, Oriental Insurance Company, and United India Insurance Company** — are government-owned companies and are public authorities under the RTI Act. You can send an RTI application to their Central Public Information Officer (CPIO) to ask for:
 +
 +  * The status of your claim and the reasons for any delay, in writing.
 +  * Copies of internal guidelines or circulars issued to their TPAs about claim processing timelines.
 +  * The complaint disposal statistics for their grievance cells.
 +
 +Each of these companies has RTI compliance pages on their official websites where CPIO contact details are published. RTI applications must be submitted in hard copy (email filings are not accepted) with the prescribed fee, as per each company's RTI notices. See our guide on [[/file-rti-online-india|how to file an RTI application]] for the general process, and [[/file-first-appeal-rti-section-19-2026|how to file a first appeal]] if the CPIO does not respond.
 +
 +==== If the hospital is a government or public hospital ====
 +
 +Public hospitals (government-run district hospitals, AIIMS, ESI hospitals, and similar institutions) are public authorities. If a government hospital's insurance desk mishandled your pre-authorisation request or failed to send documents to the TPA on time, you can file an RTI with the hospital to get the internal records of what was sent and when.
 +
 +==== For IRDAI records ====
 +
 +IRDAI is a statutory regulator and a public authority. You can file an RTI with IRDAI to obtain aggregate complaint statistics, insurer compliance data, or information about the regulatory framework that applies to your situation. RTI applications to IRDAI are filed with their CPIO in Hyderabad.
 +
 +===== When RTI will not help =====
 +
 +**Private health insurers are not public authorities** under the RTI Act. You cannot send an RTI application to Star Health, HDFC ERGO, ICICI Lombard, Niva Bupa, Care Health, Aditya Birla Health Insurance, or any other private insurer. RTI applications sent to private insurers will be rejected or simply ignored.
 +
 +**Private TPAs are also not public authorities.** Medi Assist, Paramount, HealthIndia, MD India, Raksha TPA, and similar private TPAs cannot be compelled to respond to RTI applications.
 +
 +For disputes with private insurers and private TPAs, your remedies are the insurer's GRO, IRDAI Bima Bharosa, the Insurance Ombudsman, and the Consumer Forum — all of which are described in this guide. See our companion guide on [[/file-insurance-complaint-irdai-2026|how to file an insurance complaint with IRDAI]] for the full detail.
 +
 +For those with public-sector insurer policies, RTI is a useful //parallel// tool — not a replacement for the grievance route. Filing a formal grievance with the GRO and Bima Bharosa will usually be faster.
 +
 +===== Common mistakes to avoid =====
 +
 +  * **Only talking to the hospital desk, not the TPA directly.**
 + Hospital desk staff pass messages between you and the TPA but have no authority to compel the TPA. Call the TPA helpline yourself and create a paper trail.
 +  * **Assuming the TPA and the insurer are the same entity.**
 + The TPA processes the paperwork; the insurer makes the final decision and is ultimately responsible for delay penalties. Always escalate to the insurer if the TPA is unresponsive — the insurer controls the TPA.
 +  * **Not getting anything in writing.**
 + A verbal approval from the TPA over the phone is not enough. Ask for written confirmation — an email, an app notification, or a printed letter from the hospital desk. Without something in writing, you cannot prove what was or was not approved.
 +  * **Leaving the hospital without collecting original documents.**
 + If you pay out of pocket and plan to claim reimbursement, you need original bills, discharge summary, and reports. Hospitals are not always cooperative after you have settled the bill. Collect everything before you walk out.
 +  * **Missing the reimbursement submission deadline.**
 + Most policies require reimbursement claim documents within 30 days of discharge. Some are stricter. Check your specific policy document — the clock starts on the date of discharge, not the date you file a complaint with the insurer.
 +  * **Going straight to the ombudsman without first approaching the insurer.**
 + The Insurance Ombudsman requires you to have already approached your insurer and either [[/practical-guides/health-insurer-closes-grievance-without-answer|received no response within 30 days]] or received an unsatisfactory one. Skipping the insurer step makes your ombudsman complaint procedurally weak.
 +  * **Sending an RTI application to a private insurer.**
 + The RTI Act does not apply to private insurance companies. Sending such an application wastes time you could spend on the effective remedies — the GRO, Bima Bharosa, or the ombudsman. See the [[#rti-angle|RTI section]] above for what RTI can actually help with.
 +  * **Not mentioning the IRDAI timeline in your complaint.**
 + Insurers respond faster when a written complaint explicitly cites the IRDAI Master Circular requirement. Use the template above, which already includes this reference.
 +
 +===== Official links =====
 +
 +  * [[https://bimabharosa.irdai.gov.in/RegComplaint/RegisterComplaint|Register a complaint — IRDAI Bima Bharosa portal]]
 +  * [[https://policyholder.gov.in/how-to-make-a-complaint|How to make a complaint — IRDAI Policyholder website]]
 +  * [[https://policyholder.gov.in/ombudsman|Insurance Ombudsman — offices, eligibility, and process]]
 +  * [[https://policyholder.gov.in/irda-grievance-call-centre|IRDAI Grievance Call Centre — 155255 / 1800-4254-732]]
 +  * [[https://irdai.gov.in/faqs-on-health-insurance-regulations|IRDAI — FAQs on health insurance regulations]]
 +  * [[https://www.newindia.co.in/right-to-information/rti-compliance|New India Assurance — RTI compliance (for PSU policy holders)]]
 +
 +===== Frequently asked questions =====
 +
 +==== How long does an insurer have to approve a cashless claim after the hospital submits the request? ====
 +
 +Under IRDAI's Master Circular on Health Insurance Business (effective 31 July 2024), insurers must issue pre-authorisation within one hour of receiving the request from the hospital. Final discharge authorisation must be issued within three hours. If the insurer misses the three-hour discharge deadline, any extra hospital charges caused by that delay must be borne by the insurer, not by you.
 +
 +==== The hospital says the TPA has not responded. What should I do first? ====
 +
 +Ask the hospital's insurance desk for the TPA's direct helpline number and call it yourself with your policy number and claim reference number. Simultaneously, call your insurer's toll-free number printed on your health card or policy document and log a verbal complaint, noting the name of the person you spoke to. If you still get no response within a reasonable time, send a written email to the insurer's Grievance Redressal Officer (GRO) — contact details are on your policy document and insurer's website.
 +
 +==== Can I switch to a reimbursement claim if the cashless approval is taking too long? ====
 +
 +Yes. If the cashless route is stalled and you or your family need to pay the hospital bill to enable discharge, you can pay out of pocket and file a reimbursement claim with your insurer after discharge. Collect all original bills, the discharge summary, investigation reports, and prescriptions before leaving the hospital. Most policies require you to submit reimbursement documents within 30 days of discharge, but check your specific policy document for the exact deadline.
 +
 +==== What is Bima Bharosa and when should I use it? ====
 +
 +Bima Bharosa is IRDAI's integrated grievance redressal portal at bimabharosa.irdai.gov.in. Use it when your insurer has not resolved your complaint satisfactorily or has not responded within the required timeframe. You register your complaint online, upload documents, and get a complaint reference number. IRDAI requires insurers to resolve complaints within 14 days of the complaint being registered. If the insurer still does not act, the complaint can be escalated to the Insurance Ombudsman.
 +
 +==== Does the RTI Act apply to my private health insurer or TPA? ====
 +
 +No. The Right to Information Act, 2005 applies only to public authorities. Private insurers (such as HDFC ERGO, ICICI Lombard, Star Health, Niva Bupa, and so on) and private TPAs are not public authorities and cannot be sent RTI applications. However, if your policy is with a public-sector general insurer — such as New India Assurance, National Insurance, Oriental Insurance, or United India Insurance — those companies are public authorities and their records are accessible under the RTI Act.
 +
 +==== What documents must I collect at the hospital before discharge? ====
 +
 +Before you leave the hospital, collect: the original discharge summary signed by the treating doctor; the itemised final bill showing all charges broken down; all investigation and lab reports (blood tests, scans, X-rays); the pre-authorisation approval letter or message from the TPA; copies of all prescriptions; and your payment receipts if you paid anything. If the cashless claim was approved, keep the insurer's written approval confirmation. Take clear photographs of everything before handing over originals to the hospital.
 +
 +==== When can I complain to the Insurance Ombudsman? ====
 +
 +You can approach the Insurance Ombudsman if you have already lodged a complaint with your insurer and either received no response within 30 days, or received a response that does not resolve your problem to your satisfaction. The ombudsman can hear disputes where the claim value does not exceed the prescribed limit (check the current limit on policyholder.gov.in). The process is free, you do not need a lawyer, and there are ombudsman offices in major cities across India.
 +
 +{{tag>irdai insurance cashless health approval delayed tpa hospital}}