Consumer court case against an insurance company — how to file

A rejected or short-paid health claim is a "deficiency in service" under the Consumer Protection Act, 2019. File within two years with the District Consumer Commission (where the premium paid is up to ₹50 lakh — almost every health policy), online on e-Jagriti. You can claim the amount, interest, compensation for harassment and costs. A legal notice to the insurer usually comes first.

Step by step

1. Send a legal notice

   A notice to the insurer giving 15 days to pay. It often settles the matter, and the reply sharpens your complaint.

2. Pick the commission

   District Commission where the consideration paid (the premium) is up to ₹50 lakh; State Commission up to ₹2 crore. File where you live or work, or where the insurer has an office.

3. Draft the complaint

   Parties, facts in date order, the deficiency in service, the documents, the limitation, and the prayer (relief).

4. File online on e-Jagriti

   Register, upload the complaint, the affidavit and the documents, and pay the fee online. Paper filing is also accepted.

5. Admission and hearings

   The commission admits the complaint, issues notice to the insurer, and hears both sides. Many hearings are now by video.

Fee

There is no fee where the consideration paid is up to ₹5 lakh — which covers nearly every health insurance premium. Above that a small fee applies by slab, paid online.

Prayer — what to ask for

• Payment of the claim amount of ₹[ ]
• Interest from the date the claim should have been paid
• Compensation for mental agony and harassment
• Costs of the complaint

Ombudsman first?

If the claim is under ₹50 lakh and within a year of the insurer's reply, the Insurance Ombudsman is free and usually faster. If the Ombudsman has already decided the complaint, you can still go to the consumer commission if you do not accept the award.

Related guides

• Consumer court for a rejected claim
• Legal notice to an insurer
• Insurance Ombudsman complaint — format
• Legal help for a rejected claim
• Time limits — grievance, Ombudsman, consumer court
• All rejected-claim guides

What is the time limit to file a consumer complaint against an insurer?

Two years from the date of the rejection (the cause of action). A delay can be condoned for sufficient reason.

Can I file a consumer complaint against an insurance company online?

Yes, on e-Jagriti, the national consumer commission filing portal.

Do I need a lawyer in consumer court?

No, you can appear yourself. Many people choose legal help for the drafting and the hearings.