Rejected claim help centre

Plain guides to getting a rejected, delayed or short-paid health insurance claim paid in India — from the first letter to the Insurance Ombudsman and the consumer court. Written by the Medilock recovery desk and checked against the IRDAI rules.

Guides

• Claim rejected? What to do — The complete route from a rejection letter to the money: grounds, documents, grievance, Ombudsman, consumer court.
• Insurance Ombudsman complaint — Who can complain, the one-year limit, the ₹50 lakh cap, how to file online and what happens at the hearing.
• Consumer court for a rejected claim — Filing a consumer complaint against an insurer: which commission, the two-year limit, e-Jagriti, fees and what you can claim.
• Legal help for a rejected claim — Legal assistance for rejected, delayed and short-paid claims — Ombudsman, consumer court, legal notice. Fee only on what you receive.
• IRDAI complaint (Bima Bharosa) — Escalating to the regulator after the insurer: the 14-day rule, the portal, the helpline and what to write.
• Legal notice to an insurer — When a legal notice helps, what it must say, and how to send it so it counts later.
• Common rejection reasons — Ten reasons insurers give for rejecting a claim, and the answer to each.
• Rejected for pre-existing disease / non-disclosure — The 36-month waiting cap, the 60-month moratorium, and how to answer a non-disclosure rejection.
• Cashless claim rejected — for hospitals — For hospitals: approved but unpaid, rejected after discharge, short-paid or closed without intimation.
• Claim delayed or pending for months — The 30-day settlement rule, interest on delay, repeated queries, and how to force a decision.
• Claim short-paid or deducted — Room-rent proportionate deduction, co-pay, non-payable items and "reasonable and customary" cuts.
• क्लेम रिजेक्ट होने पर क्या करें (हिंदी) — हेल्थ इंश्योरेंस क्लेम रिजेक्ट होने पर कदम-दर-कदम: शिकायत, बीमा भरोसा, बीमा लोकपाल और उपभोक्ता अदालत।