How do I write a complaint email to my insurance company?

Make it a clear written complaint, not a query: a subject line with your policy and claim numbers, then short paragraphs on who you are, what happened, what the insurer decided, why you disagree and what you want, and a numbered list of attachments. Keep to facts your documents can show. The outline below uses placeholders in square brackets; replace every one with your own details.

An email to your insurer counts as a written complaint: IRDAI's definition of a complaint expressly includes electronic mail. A plain inquiry or a service request, on the other hand, is not treated as a complaint at all. So the first job of your email is to say, in so many words, that you are registering a complaint.^[1]

Before you start writing

• Your numbers: Policy number, claim number and any earlier complaint reference. If the complaint later goes to Bima Bharosa, the claim number is mandatory there for claim-related complaints, so get it right from the start.^[2]
• The decision you are answering: The rejection, settlement or other letter, its date, and the exact words of the reason it gives.
• The clause: The policy clause the insurer relied on, read in full in your own policy wording, not just the line quoted in the letter.
• Your evidence: Copies, not originals, of the documents that answer the reason: medical records, bills, earlier policies, earlier emails.
• The right address: Your insurer's grievance email address. Every insurer must publicise its grievance redressal procedure; finding your insurer's Grievance Redressal Officer explains where to look.^[1]

The structure, part by part

1. 1

   Subject line

   Complaint – Policy [policy number] – Claim [claim number] – [insured person's name]. A subject that starts with the word 'Complaint' and carries both numbers is easy to register and easy to find later.

2. 2

   Opening sentence

   'I am writing to register a complaint about [the rejection / the deduction / the delay] on the claim above.' One sentence that leaves no doubt this is a complaint and not a request for information.

3. 3

   Who you are

   Your name, how you are connected to the policy (policyholder, insured person, nominee), and a phone number and email address for the reply.

4. 4

   What happened, with dates

   The facts in date order: when the policy began, when the treatment, accident or death happened, when you claimed, and the date of the decision. Dates do more work than adjectives.

5. 5

   What the insurer said

   Quote the stated reason exactly as written, with the clause number it cites. If the letter cites no clause, say so plainly.

6. 6

   Why you disagree

   Answer that reason with facts and the clause wording, one point per paragraph, each pointing to an attachment by its number ('see attachment 3'). Leave out anything you cannot show.

7. 7

   What you are asking for

   Name the relief: reconsideration and payment of the claim or the amount deducted, or at least a reasoned decision that refers to the policy terms. What to ask for in a grievance sets out the options.

8. 8

   Attachments

   A numbered list that matches the file names of what you attach: 1. [rejection letter, date]; 2. [policy schedule and wording]; 3. [document, date].

9. 9

   Closing

   Ask for an acknowledgement with a complaint reference number, and end with your full name, the date and your contact details.

A fill-in outline

Mistakes that weaken a complaint email

• A question instead of a complaint: 'Why was my claim rejected?' reads as an inquiry, and an inquiry is not a complaint under IRDAI's definition. 'I am registering a complaint about…' leaves no room for doubt.^[1]
• Several problems in one email: IRDAI's own paper complaint form asks for a separate form for each complaint. Separate emails for separate problems are easier to track for the same reason.^[3]
• Fairness instead of terms: 'This is unfair' gives the reader nothing to check. 'Clause [number] excludes [X]; my condition is [Y], shown by attachment 2' does.
• No dates or numbers: Without the claim number and the decision date, the first reply may simply ask you for them, which costs you time.
• Originals as attachments: Send copies and keep the originals. See whether to send original documents.

After you press send

Keep the sent email and its attachments exactly as sent. IRDAI's master circular says the insurer must acknowledge a complaint immediately and should resolve it within 14 days, and if it does not accept your complaint its resolution should give reasons with specific reference to the policy terms. How long the insurer has to reply explains that clock, and what to do if no reply comes covers silence.^[4]

ClaimAssure is an independent private platform. It is not an insurer, IRDAI, Bima Bharosa or the Insurance Ombudsman, it never files anything on your behalf, and it cannot promise any outcome. What it does is read your documents and show you what they say.

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