Your claim is taking too long. What you can do.

Written for policyholders in India · Last reviewed 2026-10-10

A claim that is neither paid nor refused is its own problem: there is no decision to argue with. But the insurer is working to time limits too, and under IRDAI's 2024 master circular a claim settled late carries interest from the date the insurer received your intimation — so the first job is to put the delay on the record.

Establish what is actually outstanding

Ask, in writing, what the insurer is waiting for. Vague requests for "further documents" are worth answering with a specific question: which document, for which fact, under which clause.

Keep every reply. A sequence of dated requests and responses is the evidence a grievance rests on.

Know the turnaround expectations

Under IRDAI's 2024 master circular, a health reimbursement claim is to be settled within fifteen days of submission, a life death claim within 15 days of intimation (45 days where investigation is needed), and a motor claim decided within seven days of the survey report. An insurer should also resolve a complaint within 14 days.

Rules change, so check the current circular before relying on a figure — but do not let that stop you asking the insurer, in writing, why a limit has passed.

Turn the delay into a written grievance

If the wait is unreasonable and the insurer's replies are not moving it, the delay itself is the complaint. Write to the grievance officer setting out the dates: when you claimed, what was asked, what you sent, and what has happened since.

Ask for a decision, in writing, with reasons. A claim that is refused can be answered; a claim that is neither refused nor paid leaves you with nothing to answer, which is why getting a decision is worth asking for in its own right.

What can hold a claim up

Knowing the cause tells you what to chase. These are causes worth asking about, and several of them are things you can move.

A document the insurer says is missing: For example, a discharge summary, an investigation report or a bank mandate. Ask exactly which document and for which fact, then send it with a covering note and keep proof of sending. IRDAI's 2024 master circular says a claim cannot be rejected or closed only for want of documents.
An investigation: Some claims are referred for field verification. Ask whether yours has been, and to whom it is assigned — a claim waiting on an investigator is a different problem from a claim waiting on a desk.
A query the hospital has to answer: Where treatment details are queried, the insurer may be waiting on the hospital rather than on you. Chase both, and ask the hospital's insurance desk for a copy of what they sent.
A transfer between teams: Cashless and reimbursement can be handled by different desks, and a claim can sit between them. A reference number and a named contact help stop that.

Keep the record while you wait

Every call is worth a line: the date, who you spoke to, what they said, and any reference number given. Follow a call with a short email repeating what was said, so that the record exists in writing rather than only in your memory.

If this eventually goes to a grievance officer, the regulator's portal or the Ombudsman, that sequence of dates is the case. A delay is proved by a chronology, not by frustration.