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| + | ====== Personal accident claim not showing on the insurer' | ||
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| + | **If your personal accident claim does not appear on the insurer' | ||
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| + | **Reviewed on:** 2026-05-29. | ||
| + | |||
| + | {{: | ||
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| + | //When your personal accident claim does not appear on the insurer' | ||
| + | |||
| + | <WRAP center round info 95%> | ||
| + | **Quick Reply:** | ||
| + | |||
| + | If you have filed a personal accident claim — for an accidental injury, disability or death, on a standalone accident policy, a policy rider, or a scheme like the bank-linked **Pradhan Mantri Suraksha Bima Yojana (PMSBY)** — and it does not show up on the insurer' | ||
| + | |||
| + | If the insurer cannot confirm registration or stays silent, you escalate — not with RTI first, but through the insurance grievance chain: the insurer' | ||
| + | </ | ||
| + | |||
| + | ===== Who this guide is for ===== | ||
| + | |||
| + | This guide is for you if you filed a personal accident claim and it is not visible in the insurer' | ||
| + | |||
| + | * You submitted an accident claim and got an acknowledgement, | ||
| + | * You filed a **PMSBY** accident claim through your bank branch, and neither the bank nor the insurer' | ||
| + | * The portal shows your policy but says 'no claims found', | ||
| + | * A family member is claiming after an accidental death or disability, and the claim they lodged does not appear under the policy online. | ||
| + | * You were given a claim or token number, but it returns ' | ||
| + | |||
| + | ===== What you can do this weekend ===== | ||
| + | |||
| + | ==== Friday evening ==== | ||
| + | |||
| + | Fix the facts and find your proof first. The whole case turns on showing that you intimated the claim — so gather every scrap that proves you filed. | ||
| + | |||
| + | * Find your **intimation proof**: the claim acknowledgement, | ||
| + | * Note your **policy number**, the claim or token number you were given, the date of the accident, and the channel you used (app, website, branch, bank, agent or toll-free line). | ||
| + | * Keep the accident records together — FIR or police report, hospital and disability papers, post-mortem if any — so you are ready the moment the claim is traced. | ||
| + | |||
| + | ==== Saturday ==== | ||
| + | |||
| + | Put the missing claim on the record in writing. Email the insurer' | ||
| + | |||
| + | * Quote your policy number, the date of the accident, the date you intimated, and any claim or token number you were given. | ||
| + | * State clearly that the claim is not visible on the portal/app, and ask them to confirm whether it is registered and under what claim number. | ||
| + | * Ask them to acknowledge your email with a reference number and to tell you the current status and any pending document. | ||
| + | |||
| + | ==== Sunday ==== | ||
| + | |||
| + | Pull your file together and plan the escalation. Read your policy on how to intimate and pursue an accident claim, and get ready to move up the chain if Monday' | ||
| + | |||
| + | * Save every message, call log and screenshot in one folder, with dates, so your timeline is clean and complete. | ||
| + | * Note the insurer' | ||
| + | * Plan Monday: send the confirm-registration email, call the branch or toll-free line for a reference, and diarise when you will escalate to the GRO and then Bima Bharosa if nothing moves. | ||
| + | |||
| + | ===== Documents and evidence checklist ===== | ||
| + | |||
| + | ^ Document or evidence ^ Why it matters / where to get it ^ | ||
| + | | Proof you intimated the claim | The acknowledgement, | ||
| + | | Policy schedule or certificate | Shows your policy number, the cover, who is insured and the nominee. For a scheme like PMSBY, keep the enrolment confirmation or the bank's auto-debit entry showing you were covered. | | ||
| + | | Claim or token number, if given | Note any reference the insurer or app gave you when you filed; it helps them trace a claim that is registered under a different number or stuck in their system. | | ||
| + | | FIR or police report (where relevant) | For road, rail or similar accidents, drowning or any accident involving a crime, the police report is usually required; keep a copy and note its number and date. | | ||
| + | | Hospital, disability or death records | Discharge summary, disability certificate from the competent authority, or the death certificate and post-mortem — these are the core proofs the insurer needs once the claim is traced. | | ||
| + | | Bank passbook or account statement page | Accident claim payouts are credited to a bank account, so the first pages of the passbook or a statement showing account details are usually part of the claim file. | | ||
| + | | All correspondence with the insurer and bank | Every email, SMS, call log, agent message and portal screenshot, with dates — this trail proves you filed and chased while the claim stayed invisible online. | | ||
| + | | A short dated timeline you write yourself | A one-page sequence — accident, intimation, the reference you got, your follow-ups, the 'not found' screens — keeps your case clear at every later level. | | ||
| + | |||
| + | ===== Step-by-step action plan ===== | ||
| + | |||
| + | - **Find and date your proof of intimation.** Locate the acknowledgement, | ||
| + | - **Do not refile blindly or change details.** Resist the urge to submit a fresh claim just because nothing shows online. A duplicate can create two part-filled claims and confusion. First get the existing one traced. If you must file again because no record exists at all, do it in writing, reference your earlier intimation date, and keep both acknowledgements. | ||
| + | - **Ask the insurer to confirm registration in writing.** Email the insurer' | ||
| + | - **Check the bank or branch if a scheme was used.** For a scheme like PMSBY, the claim is usually filed through your bank branch, which forwards it to the insurer. If it is not showing, ask the branch in writing whether and when they forwarded your claim-cum-discharge form to the insurer, and get that confirmation, | ||
| + | - **Follow up and keep the whole trail.** If you get no clear answer, follow up in writing every few days and save every reply, call log and screenshot. A clean dated trail of your follow-ups and their silence is exactly what later levels need, so keep it all in one folder with your timeline. | ||
| + | - **Escalate to the Grievance Redressal Officer.** If the claims team still cannot confirm your claim, write to the insurer' | ||
| + | - **Register a complaint on IRDAI Bima Bharosa.** If the insurer does not resolve it in a reasonable time, register your grievance on IRDAI' | ||
| + | - **Use RTI only if a public body holds your record.** If a public-sector general insurer, LIC, a PSU bank that should have forwarded your PMSBY claim, or ESIC is involved, file an RTI with its Public Information Officer asking whether and when your claim was registered or forwarded, and the file notings. This proves the gap; it does not by itself pay you. | ||
| + | - **Approach the Ombudsman or a consumer forum.** If the claim is still lost and the insurer ignores you, take it to the Insurance Ombudsman through cioins.co.in within the time limit in the Ombudsman Rules, which is free for policyholders. For deficiency of service, you can also file before a consumer commission on e-Daakhil at e-jagriti.gov.in. | ||
| + | |||
| + | ===== Escalation ladder ===== | ||
| + | |||
| + | ^ Step ^ Who to approach ^ How to reach them ^ Typical timeline ^ | ||
| + | | Insurer claims team | The insurer (or the bank branch, for a bank-linked scheme like PMSBY) where you filed the claim | Written email asking to confirm registration, | ||
| + | | Bank branch (for scheme claims) | The branch that took your PMSBY claim-cum-discharge form | Written request asking whether and when they forwarded your claim to the insurer, with the date | A few days to a couple of weeks | | ||
| + | | Insurer' | ||
| + | | IRDAI Bima Bharosa | Insurance Regulatory and Development Authority of India grievance portal | Register at bimabharosa.irdai.gov.in and keep the token to track it | As per the portal' | ||
| + | | Insurance Ombudsman | Office of the Insurance Ombudsman for your area | File through cioins.co.in within the limit set by the Insurance Ombudsman Rules; free for policyholders | A few weeks to a few months | | ||
| + | | Consumer Disputes Redressal Commission | District or State Consumer Commission | File online on e-Daakhil at e-jagriti.gov.in with your full evidence | Varies by location and case load | | ||
| + | |||
| + | ===== Copy-paste complaint template ===== | ||
| + | |||
| + | Adapt the bracketed parts. Keep a copy of everything you send. | ||
| + | |||
| + | **Subject: | ||
| + | |||
| + | < | ||
| + | To: The Claims Team / Grievance Redressal Officer | ||
| + | [Insurance company name] (copy to bank branch [branch name] and agent/ | ||
| + | |||
| + | Subject: My personal accident claim is not visible on your portal/app — request to confirm registration, | ||
| + | |||
| + | Dear Sir / Madam, | ||
| + | |||
| + | I am the policyholder/ | ||
| + | |||
| + | Claim details: | ||
| + | - Policy / certificate number: [policy number] | ||
| + | - Scheme (if any): [e.g. standalone accident policy / rider / PMSBY through bank] | ||
| + | - Date of accident: [date] | ||
| + | - Date I intimated the claim: [date], by [app / website / branch / bank / agent / toll-free], reference [reference if any] | ||
| + | - Claim / token number given to me (if any): [number] | ||
| + | - Nature of claim: [accidental injury / disability / death] | ||
| + | - Insured person: [name] | ||
| + | |||
| + | Despite my intimation and follow-ups on [dates], the claim is not showing as registered on your portal/app, and the status check returns no record / an invalid reference. I have not refiled, to avoid creating a duplicate. | ||
| + | |||
| + | I request you to: | ||
| + | 1) Confirm in writing whether my claim is registered, and under which claim number. | ||
| + | 2) Tell me the current status and any document still pending from me. | ||
| + | 3) If it was to be forwarded by my bank branch under a scheme, confirm whether and when it was received by you. | ||
| + | 4) Acknowledge this email with a reference number. | ||
| + | |||
| + | I am attaching my proof of intimation, the policy/ | ||
| + | |||
| + | If my claim cannot be confirmed as registered within a reasonable time, I will be constrained to escalate to your Grievance Redressal Officer, IRDAI' | ||
| + | |||
| + | Thank you. | ||
| + | |||
| + | Name: [your name] | ||
| + | Policy number: [policy number] | ||
| + | Claim/token number (if any): [number] | ||
| + | Mobile: [number] | ||
| + | Email: [email] | ||
| + | Date: [date] | ||
| + | </ | ||
| + | |||
| + | ===== When RTI can help ===== | ||
| + | |||
| + | RTI is useful here only in a narrow situation — when a **public authority holds part of your record** — and even then it is an evidence and pressure tool, not a way to force a payout. The real openings are: | ||
| + | |||
| + | * **A PSU bank that was meant to forward your claim.** Accident cover under the bank-linked PMSBY scheme is claimed through your bank branch, which forwards the claim to the insurer. If that bank is a public-sector bank, it is a public authority, and you can file an RTI asking //whether and on what date your claim-cum-discharge form was forwarded to the insurer, and the related notings//. This is often where a ' | ||
| + | * **A public-sector (government) general insurer or LIC.** The government-owned general insurers and LIC are public authorities. If your accident policy or rider is with one of them, you can file an RTI for your own claim asking //whether and when the claim was registered, the claim number allotted, and the claim-file notings// — which is exactly what proves it was or was not entered in their system. | ||
| + | * **ESIC, for an employment accident.** If your accident is being claimed as an employment injury or disablement benefit, ESIC is a public authority, and RTI can ask for the status and registration of your claim with the local office. | ||
| + | |||
| + | These answers carry real weight at the Grievance Redressal Officer, the Insurance Ombudsman or a consumer commission, because they show, in the public body's own records, exactly where your claim went missing. | ||
| + | |||
| + | ===== When RTI will not help ===== | ||
| + | |||
| + | For the most common situation — a **private insurer' | ||
| + | |||
| + | For a private accident-insurance problem, use the insurance grievance chain instead: a written request to the insurer' | ||
| + | |||
| + | ===== Common mistakes to avoid ===== | ||
| + | |||
| + | * Trusting the portal over your paperwork — the app is only a display screen; your proof of intimation is what legally fixes that you filed, so guard it. | ||
| + | * Refiling a fresh claim the moment nothing shows online, creating two part-filled claims and confusion instead of getting the first one traced. | ||
| + | * Chasing only by phone and never in writing, so you have no proof that you asked the insurer to confirm registration and they stayed silent. | ||
| + | * Forgetting the bank hand-off in a scheme claim like PMSBY — if the branch never forwarded your form, the insurer' | ||
| + | * Filing an RTI against a private insurer, which is outside the RTI Act; use the insurance grievance chain, and save RTI for a PSU bank, a public-sector insurer, LIC or ESIC. | ||
| + | * Letting the escalation clock run out — the Insurance Ombudsman has time limits, so diarise dates and escalate in writing rather than waiting on promises. | ||
| + | |||
| + | ===== Official links ===== | ||
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| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | |||
| + | ===== FAQs ===== | ||
| + | |||
| + | ==== My accident claim is not on the portal — does that mean it was rejected? ==== | ||
| + | |||
| + | No. Not showing on the portal is not the same as rejected. It usually means the claim is not registered yet, is registered under a different number, is stuck at a bank or branch that should have forwarded it, or is simply not syncing to the app. Your proof of intimation is what counts. Ask the insurer in writing to confirm whether the claim is registered and under what number. | ||
| + | |||
| + | ==== What should I do first if my claim does not appear online? ==== | ||
| + | |||
| + | Find your proof that you filed — the acknowledgement, | ||
| + | |||
| + | ==== Should I just file the claim again to be safe? ==== | ||
| + | |||
| + | Be careful. Refiling can create two part-filled claims and slow everything down. First get the existing claim traced and confirmed. If the insurer genuinely has no record at all, then file again in writing, refer to your earlier intimation date, and keep both acknowledgements. Never quietly change the accident date or details between filings, as mismatches can hurt the claim later. | ||
| + | |||
| + | ==== I filed a PMSBY claim through my bank but nothing shows — what now? ==== | ||
| + | |||
| + | Under PMSBY, the accident claim is given to your bank branch, which forwards it to the insurer. If nothing shows, the gap is often at that hand-off. Ask the branch in writing whether and when they forwarded your claim-cum-discharge form to the insurer, and get that in writing. If the bank is a public-sector bank, RTI can also confirm whether and when your claim was forwarded. | ||
| + | |||
| + | ==== Can RTI force the insurer to register or pay my claim? ==== | ||
| + | |||
| + | No. RTI never compels registration or payment, and against a private insurer it does not even apply. RTI only gives you information, | ||
| + | |||
| + | ==== When does RTI actually help with a missing accident claim? ==== | ||
| + | |||
| + | Only when a public body holds part of your record. If a PSU bank was meant to forward your PMSBY claim, or a public-sector general insurer, LIC or ESIC is involved, you can file an RTI asking whether and when your claim was registered or forwarded, the claim number, and the file notings. That proves where the claim went missing, which strengthens your complaint at the Ombudsman or a consumer forum. | ||
| + | |||
| + | ==== How long should the insurer take to confirm registration? | ||
| + | |||
| + | There are timelines for acknowledging and processing claims under IRDAI' | ||
| + | |||
| + | ==== Which documents should I keep ready? ==== | ||
| + | |||
| + | Keep your proof of intimation, the policy or PMSBY enrolment details, any claim or token number, the FIR or police report where relevant, the hospital, disability or death records, the bank passbook page, all correspondence with the insurer and bank, and a short dated timeline. These are needed at every escalation level and before the Ombudsman or a consumer commission. | ||
| + | |||
| + | ===== Clear next steps ===== | ||
| + | |||
| + | * Find your proof of intimation and note the policy number, any claim or token number, the accident date and the channel you used to file. | ||
| + | * Do not refile blindly — get the existing claim traced first, and keep every acknowledgement together. | ||
| + | * Email the insurer (and the bank branch, for a PMSBY claim) asking them to confirm registration, | ||
| + | * Save every reply, call log and screenshot in one folder, and note the insurer' | ||
| + | * If nothing moves, plan your Bima Bharosa complaint, and use RTI only if a PSU bank, a public-sector insurer, LIC or ESIC holds your record. | ||
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