The insurer hasn't replied to my complaint. What can I do now?

First check the dates: under IRDAI's master circular an insurer should resolve a complaint within 14 days of receiving it. If that has passed, send one reminder quoting your complaint reference, and write to any escalation contact the insurer lists. You can also approach IRDAI through Bima Bharosa, its helpline or email, and once a month passes after the insurer received your written complaint without a reply, you can go to the Insurance Ombudsman, within its one-year limit and subject to its other conditions.

Silence from an insurer is one of the situations the Insurance Ombudsman Rules provide for, and there is a clear way forward. What you can do depends on how long it has been, and on what proof you have that the complaint arrived.^[1]

First, make sure the complaint was received

An insurer must acknowledge a complaint immediately. If you never got an acknowledgement, check how you sent it: an email in your sent folder, a postal receipt, a reference number from a call, or a dated stamp from a branch. If you complained on Bima Bharosa or the insurer's grievance portal, the status shows there, and you can also ask the insurer's call centre.^[2]

Also check whether the insurer wrote to you asking for something. Look in spam folders and old post before you treat the matter as silence, and if you find a question, answer it and keep proof.

What you can do, step by step

1. 1

   Count the days

   Count from the date the insurer received your complaint. If 14 days have passed without a resolution, the insurer is past the timeline in IRDAI's master circular.^[2]

2. 2

   Send one reminder

   Write to the Grievance Redressal Officer again, quoting your complaint reference and date, attaching your original complaint, and asking for a reasoned reply. Keep it short and factual.

3. 3

   Escalate inside the insurer

   If the insurer's grievance page lists escalation contacts above the Grievance Redressal Officer, send the reminder to the next level as well.

4. 4

   Approach IRDAI

   IRDAI's Bima Bharosa FAQ says that if a complaint is not resolved within two weeks you can approach IRDAI's Grievance Redressal Cell: on the toll-free number 155255, by email to complaints@irdai.gov.in, on Bima Bharosa, or by post. A complaint already on Bima Bharosa moves to 'Escalated' in its status flow when the target time is crossed.^{[3, 4]}

5. 5

   Consider the Insurance Ombudsman

   If you have had no reply within one month after the insurer received your written complaint, the Insurance Ombudsman Rules allow a complaint to the Ombudsman, provided the other conditions are met. See whether you can go to the Insurance Ombudsman.^[1]

Two dates to write down

The Insurance Ombudsman Rules count silence in two ways. The right to complain for want of a reply arises when you have had no reply within one month after the insurer received your complaint. The one-year deadline in that case runs from the end of one month after you sent it. So note both the date you sent the complaint and the date it was received.^[1]

If the year passes, the Ombudsman has power to condone the delay after calling for the insurer's objections, but that is the Ombudsman's discretion; do not plan around it.^[1]

Does a Bima Bharosa complaint count as complaining to the insurer?

A complaint registered on Bima Bharosa flows into the insurer's own system as well as IRDAI's records. But the Insurance Ombudsman Rules require a representation to the insurer in writing, by email or online through the insurer's website, and no official text we have checked says whether a Bima Bharosa complaint on its own meets that. The careful course is to write to the insurer or its GRO directly as well, and keep the proof.^{[3, 1]}

What to keep together

• Your complaint exactly as sent, with its attachments.
• Proof of sending and any acknowledgement or complaint reference.
• Your Bima Bharosa token number, if you used the portal: IRDAI and the insurer use it to track the complaint.^[4]
• Every reminder, and a note of each call: the date, the number you called and any reference you were given.

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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