Complaint letter to your insurer's grievance officer

My insurer rejected, delayed or part-paid my claim. How do I complain in writing?

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Write to the insurer first. Regulation 5(5) of the IRDAI Protection of Policyholders' Interests Regulations, 2024 treats a written expression of dissatisfaction, an email included, as a complaint. An inquiry or a service request is not one.

The IRDAI Master Circular on Protection of Policyholders' Interests says the insurer acknowledges a complaint at once and resolves it within 14 days. If it does not accept the complaint, it gives reasons tied to the policy terms. If it has not resolved the matter, it tells you within the same 14 days that the Insurance Ombudsman and the Consumer Commission are open to you, and its reply carries the ombudsman's contact details.

The letter below names the claim, says what went wrong, asks for the claim to be settled or for written reasons, and asks for a reply within 14 days of receipt. Keep a copy and proof of delivery. Under rule 14(3)(a) of the Insurance Ombudsman Rules, 2017, a complaint to the ombudsman follows a written representation to the insurer.

Fill in the form. You see the letter first, then download it as Word to edit or as PDF to print. Download is free against a mobile number.

What you get

Insurance claim complaint letter, as a Word file to edit and a PDF to print

Example with made-up names

Complaint to the Grievance Redressal Officer

Date: 24 October 2026

To: The Grievance Redressal Officer, Sample General Insurance Company Limited, Grievance Cell, 3rd Floor, Trade Tower, Mumbai, Maharashtra 400051.

From: Anil Verma, B-14, Vasant Apartments, Pune, Maharashtra 411038. Contact: anil.verma@example.com.

Subject: Complaint about the rejection of claim CLM-88213 under policy HLT/2025/004417

Dear Sir or Madam,

I am writing to complain about the claim described below. I am dissatisfied with how the claim has been handled, and I ask that this letter be registered as a complaint.

Policy number	Kind of policy	Claim number	Date of claim	Amount claimed
HLT/2025/004417	Health	CLM-88213	12 August 2026	₹2,40,000

I made this claim on 12 August 2026. By your letter dated 20 September 2026 the claim was rejected.

The reason given in that letter is: The treatment is excluded under the policy.

I ask you to review the rejection and settle the claim. If you do not accept this complaint, please give me your reasons in writing, tied to the specific terms and conditions of the policy, with a copy of each clause you rely on.

Under the IRDAI Master Circular on Protection of Policyholders' Interests, an insurer acknowledges a complaint at once and resolves it within 14 days of receiving it. I ask for your reply within 14 days of your receiving this letter. If the complaint is not resolved, the Master Circular requires you to tell me within the same 14 days what options I have, including the Insurance Ombudsman and the Consumer Commission, and your reply should carry the contact details of the Insurance Ombudsman.

This letter is a written complaint. It is not an inquiry or a service request. Please acknowledge it and send the reply to the address or contact given above.

Yours faithfully,

Anil Verma

Fill in your own

You, the policyholder

Your name, or your business name *

Your address *

Phone number or email for the reply *

The insurer

Name of the insurance company *

Address of the grievance officer or the branch *Use the address on your policy, on the rejection letter or on the insurer's website.

Kind of policy *For example health, motor, fire, marine or term life.

Policy number *

Claim reference number *If the insurer has not given one, write: not given.

The claim

Date you made the claim *

Amount you claimed *

What went wrong? *

The letter and who signs it

Documents you are sending with the letter

Document 1

Document *For example: copy of the policy, rejection letter, claim form.

Date on the letter *Today, or any day in the next seven days.

Write the letter as *

Name of the person who signs *

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BuildWright does documentation, filing and compliance facilitation. This tool works from the rules cited on this page and does not give legal advice. We prepare the documents from your answers; you check, sign and send or file them.

If this is where you are

The insurer rejected my claim or did not reply, and I want to complain to the Insurance Ombudsman without getting the form wrong.

Insurance Ombudsman complaint on Annexure VI-A

Your complaint on Annexure VI-A filled from your facts, the mediation consent page, the list of documents to file and your last date.

Complaint to the Insurance Ombudsman (Annexure VI-A)
Consent to mediation
Documents to file
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Common questions

Who do I address the letter to?

The insurer's Grievance Redressal Officer. Use the address on your policy, on the rejection letter or on the insurer's website. The Master Circular also lets you complain by branch, email, the insurer's website or call centre, and online at IRDAI's Bima Bharosa portal. Send this letter to the insurer even if you also use Bima Bharosa.

How long does the insurer have to reply?

The Master Circular gives 14 days to resolve a complaint. Some pages on the Bima Bharosa portal still say 15 days. They were written before the 2024 Master Circular, and the letter uses 14.

What if the insurer does not reply or I am not satisfied?

You can go to the Insurance Ombudsman. Rule 14(3)(a) of the Insurance Ombudsman Rules, 2017 allows this after the insurer rejects the complaint, after a month with no reply, or after a reply that does not satisfy you. The Consumer Commission is a separate remedy.

Can a business use this letter?

Yes. Choose We, and name the person who signs and the role. Whether a business can later use the Insurance Ombudsman depends on the Rules. Individuals, sole proprietorships and micro enterprises are covered, and the Council for Insurance Ombudsmen says other bodies are not.

Source: IRDAI (Protection of Policyholders' Interests, Operations and Allied Matters of Insurers) Regulations, 2024, regulation 5(5) and its Explanation: a written expression of dissatisfaction, e-mail included, is a complaint; an inquiry or service request is not. Read 18 October 2026. In force from 1 April 2024 (regulation 1(3): publication or 1 April 2024, whichever is later). Read as the live text on irdai.gov.in on 2026-10-18.
Source: IRDAI Master Circular on Protection of Policyholders' Interests, Complaints Mechanism para 2(i) (acknowledge at once, resolve within 14 days, reasons tied to the policy terms), the turnaround schedule (options within 14 days if unresolved) and para 3(iii) (ombudsman contact details in the resolution letter). Read 18 October 2026. Read as the live 2024 Master Circular on irdai.gov.in on 2026-10-18. Older text on the Bima Bharosa portal that says 15 days predates it; 14 days is used.
Source: Insurance Ombudsman Rules, 2017 as amended, rule 14(3)(a) (the ombudsman route opens after a written representation to the insurer and a rejection, a month without a reply, or an unsatisfactory reply) and rules 2 and 3 (who is covered), with the Council for Insurance Ombudsmen FAQ 20 and FAQ 5 on individuals, sole proprietorships and micro enterprises. Read 18 October 2026. Consolidated copy as amended till 9 November 2023. The Council for Insurance Ombudsmen lists no later final amendment; a November 2025 draft amendment is still shown as a draft.

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