The insurer keeps asking for more documents — how should I respond?

Answer each request once, in writing and completely: list what was asked for, what you are sending, and anything you cannot get and why, and keep proof that you sent it. Insurers are meant to list the claim documents in the policy and ask for what they need in one go, and a missing paper on its own is not a reason to close your claim. When a new request arrives, ask in writing what it is for and whether the list is now complete.

Start with what the rules already say. Insurers must list the documents needed for a claim in the policy document and on their website, and must call for the documents the policy specifies "at one go", avoiding requests made "in a piece meal manner".^[1]

IRDAI's 2024 master circular also says no claim shall be rejected or closed for want of documents or for delayed intimation. That does not mean documents never matter — the insurer still decides the claim on its merits — but a missing paper is not, on its own, a reason to close your file.^{[2, 3]}

For a hospital claim, the health master circular goes further: the insurer and its TPA are to collect the required documents from the hospital, and the policyholder "shall not be required to submit the documents". A policy wording may still list documents for you to send, so read your own claim clause as well.^[4]

How to answer a document request

1. 1

   Get the request in writing

   If the request came by phone, ask for it by email or letter, quoting your claim number. A request you cannot point to later is a request you cannot show you answered.

2. 2

   Check it against your policy's list

   Find the claim documents clause in your policy wording. Note which requested items are on that list and which are new.^[1]

3. 3

   Send everything you have, in one reply

   One covering letter, numbered enclosures, and a copy of the whole set kept by you. Several partial replies make it hard to show what was sent when.

4. 4

   Say plainly what you cannot get

   If a hospital has not released a record, say so and attach your written request to the hospital. See how to get records from a hospital.

5. 5

   Keep proof of sending

   An email with the attachments, a courier receipt or a portal acknowledgement. See how to send so you can prove it.

6. 6

   If another request follows, ask what it is for

   Ask which fact or which policy clause the new document is needed for, and ask the insurer to confirm, in one list, everything still outstanding.^[1]

A covering letter you can adapt

1. Subject line: Claim number, policy number, patient or insured's name, and "Documents in reply to your request dated [date]".
2. What they asked: Repeat their list in their own words, numbered, so each item has a matching enclosure.
3. What is enclosed: Against each number: enclosed, or not enclosed and why.
4. What you have done about the rest: For anything missing, the date you asked the hospital, doctor or other office, with a copy of that request.
5. Your request: "Please confirm that this completes the documents you need. If anything else is needed, please list it in one reply and tell me which part of the policy requires it."
6. Contact details: Your phone number and email, and the date.

When the requests keep coming

Each request and each reply belongs in your claim timeline with its date. A run of requests, each answered, is itself evidence of where the delay sat.

If the requests look like a way of not deciding, write to the insurer's grievance officer and say clearly that you are making a complaint: under the regulations, an inquiry or service request is not treated as a complaint. An insurer should resolve a complaint within 14 days, with reasons that refer to the policy terms if it does not accept it.^{[5, 2, 3]}

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.

More on claim documents and evidence