RTI for Banking and Insurance Claim Delay (IRDAI / RBI)

If your insurance claim (life, health, motor, or property) is stuck for 30 days or more beyond the policy timeline, file an RTI to the public-sector insurer (LIC, GIC subsidiaries) directly, or to the Insurance Regulatory and Development Authority of India (IRDAI) for regulatory action. IRDAI is a statutory body and a public authority under the RTI Act, 2005. Private insurers are not public authorities, but their grievance records held by IRDAI are accessible. The RTI asks: claim status, reason for delay, surveyor report, and the dealing officer's name. Fee is Rs. 10. The PIO has 30 days to reply under §7(1).

India has around 70 crore insurance policies and 5 crore claims each year. Common delay reasons:

1. Surveyor report pending. The surveyor has not visited or submitted the report.
2. Document discrepancy. Hospital bills, KYC, or policy proof flagged as inconsistent.
3. Fraud-investigation hold. The claim is in the fraud-detection queue.
4. Pre-existing-disease dispute. The insurer disputes whether the condition was disclosed.
5. Cashless approval delay. Hospital network coordinator has not approved cashless.

The insurer's grievance cell often gives a generic answer. The RTI route works in two ways:

1. Direct RTI to a public-sector insurer (LIC, New India Assurance, United India, Oriental, National). These are public authorities. Their PIO must reply on claim status.
2. RTI to IRDAI for regulatory action. Ask for the action IRDAI has taken on your registered complaint and the consumer-grievance record.

Private insurers (HDFC Life, ICICI Prudential, Star Health, etc.) are not public authorities. RTI does not apply directly. The route is through IRDAI's regulatory record.

1. File the IRDAI grievance first. Open bimabharosa.irdai.gov.in. Get a complaint reference number. IRDAI requires 15 days for the insurer to respond.
2. If insurer is public-sector (LIC, the four GIPSA companies):
   1. PIO is at the insurer's headquarters or zonal office where your policy is registered.
3. If insurer is private:
   1. File RTI to IRDAI asking for the action on your bimabharosa complaint.
   2. Address: Public Information Officer, Insurance Regulatory and Development Authority of India, Survey No 115/1, Financial District, Nanakramguda, Gachibowli, Hyderabad 500032.
4. For banking-side issues (cheque bounce, loan-insurance dispute): File a parallel complaint with the RBI Banking Ombudsman at cms.rbi.org.in before the RTI.
5. Draft the RTI. Sample below.
6. Pay Rs. 10. IPO in favour of the addressee.
7. Send by Speed Post or file online (IRDAI and public-sector insurers are on rtionline.gov.in).
8. Track the 30-day clock. On Day 31 of PIO silence, file a First Appeal.

To,
The Public Information Officer,
[Life Insurance Corporation of India, [Zonal Office name] /
Insurance Regulatory and Development Authority of India, Hyderabad]
[Full address]

Subject: Request for information under §6(1) of the Right to
Information Act, 2005, regarding claim Number [XXXXXXXXXX] filed
on [DD-MM-YYYY] under policy [Policy Number].

Sir / Madam,

I, [Your full name], a citizen of India, residing at [Your address],
holder of policy number [XXXXXXXXXX], request the following
information under §6(1) of the RTI Act, 2005:

  Insurer: [LIC / Public-sector / Private insurer name]
  Policy Number: [XXXXXXXXXX]
  Policy Type: [Life / Health / Motor / Property / Other]
  Claim Number: [XXXXXXXXXX]
  Date of claim filing: [DD-MM-YYYY]
  Date of event (death / hospitalisation / accident): [DD-MM-YYYY]
  Claim amount: Rs. [XX,XX,XXX]
  IRDAI bimabharosa reference (if filed): [XXXXXXXXXX]

  1. Current status of the claim as on the date of this application.
  2. Date the surveyor (if applicable) was deputed, surveyor name,
     and date of report submission.
  3. Any document discrepancy noted, with the specific reference.
  4. Whether the claim is in fraud-investigation hold. If yes, the
     reason and the dealing officer.
  5. Pre-existing-disease dispute, if any, with the policy clause
     cited and the medical evidence relied upon.
  6. Name and designation of the dealing claims officer.
  7. Expected date of decision (settlement or repudiation).
  8. Action taken on the IRDAI bimabharosa complaint, if applicable.

I am enclosing Rs. 10 as the prescribed application fee by way of
Indian Postal Order No. [XXXXX] dated [DD-MM-YYYY].

Kindly supply the information within 30 days as required under §7(1)
of the Act.

Yours sincerely,

[Signature]
[Printed name]
[Phone] · [Email]
Date: [DD-MM-YYYY]
Place: [City]

• Day 1-30: PIO reply window.
• Day 31: Deemed refusal. First Appeal to the FAA (insurer's Customer Relations Head or IRDAI's Joint Director).
• Day 76: Second Appeal to the Central Information Commission.
• Parallel routes:
  1. Insurance Ombudsman under the Insurance Ombudsman Rules, 2017. Cost: free. Time: 90 days.
  2. District Consumer Commission under the Consumer Protection Act, 2019. For claims up to Rs. 50 lakh.
  3. State Commission for claims Rs. 50 lakh to Rs. 2 crore.
  4. National Commission for claims above Rs. 2 crore.

• “Surveyor report awaited.” Ask in the next RTI for the surveyor's licence number and the date of appointment. IRDAI keeps surveyor accountability records.
• “Document discrepancy.” Re-submit the document with a covering letter and copy the RTI to the discrepancy officer.
• “Pre-existing-disease dispute.” Demand the medical evidence on which the insurer relies. If the insurer cannot produce evidence, the dispute fails.
• “Claim repudiated.” A repudiation order is appealable to the Insurance Ombudsman within 90 days. The RTI is for the records supporting the appeal.
• “Private insurer, IRDAI cannot share details.” IRDAI must share the complaint-resolution record under §4(1)(b) suo-motu disclosure. Cite the rule in your First Appeal.

No. Private insurers are not public authorities under §2(h) of the RTI Act, 2005. The RTI route works through IRDAI, the regulator, for action-on-complaint records.

Yes. The Life Insurance Corporation of India is a statutory body and a public authority. Every Zonal and Branch Office accepts RTI applications.

IRDAI requires insurers to settle a claim within 30 days of receiving the last necessary document. For cashless hospitalisation, the approval window is 7 working days. Beyond these, the insurer pays interest at 2 percent above the bank rate.

Yes, in a regulatory capacity. IRDAI does not settle the claim itself; it directs the insurer to act. The RTI to IRDAI asks for the directions issued and the insurer's compliance.

For settlement of the actual claim, yes. The Ombudsman has the power to direct payment. The RTI is the route for records and evidence. File both: Ombudsman for the merits, RTI for the proof.

The standard RTI fee applies: Rs. 10 application + Rs. 2 per page photocopy. The insurer cannot charge a separate surveyor-report fee under the RTI route.

The bank is the insurer's tied agent. File a parallel complaint with the RBI Banking Ombudsman at cms.rbi.org.in. RBI is a public authority; the RBI PIO will share the complaint-resolution record.

• RTI Application Format 2026
• File an RTI online via rtionline.gov.in
• First Appeal Format with grounds checklist
• Penalty under §20
• RTI time-limit cheat sheet
• RTI for EPF withdrawal delay
• The RTI Playbook. The complete guide to filing RTI in 2026.

• The Right to Information Act, 2005. §6, §7, §19, §20.
• The Insurance Regulatory and Development Authority Act, 1999.
• The Insurance Ombudsman Rules, 2017.
• Insurance Regulatory and Development Authority of India. irdai.gov.in.
• Reserve Bank of India (Ombudsman). cms.rbi.org.in.

Last reviewed: 28 May 2026, RTI Wiki editorial team.