My insurer rejected the claim because I told them late. Can they do that?
Not on that ground alone. IRDAI's Master Circular on Protection of Policyholders' Interests, 2024 says, in its life, health and general parts alike: "No claim shall be rejected or closed for want of documents or for delayed intimation of claim" (para V.1(ii)).
You are still expected to tell the insurer as early as you can, through the insurer, its agent, the TPA, the hospital or the call centre. The policy has to say what follows when its timelines are missed, so read that clause. A delay by itself still cannot become the reason for rejection.
For a life claim, the insurer settles within 15 days of intimation, or within 45 days where it needs to investigate, and owes interest at bank rate plus 2% from intimation when it pays late. A life claim cannot be repudiated without legally tenable evidence.
Write to the insurer quoting para V.1(ii) and ask it to decide the claim on its merits. It has 14 days to resolve your complaint. If that fails, the Insurance Ombudsman takes the complaint free within one year.
If this is where you are
The insurer rejected my claim and quoted a clause. I need to answer it in writing before I can go to the ombudsman.
Appeal letter against a rejected insurance claim
A complaint letter to the insurer's grievance officer, with your policy clause and their reason set out, and a sheet with the dates that follow.
₹299₹499
Launch price until 30 November
Common questions
Does the rule cover motor and other general insurance?
Yes. The same sentence sits in the life, health and general parts of the master circular.
What is the bank rate used for the interest?
The RBI bank rate on the first day of the financial year in which the claim fell due, plus 2%. The insurer pays it without being asked.
Want this handled for you? Tell us where you stand and we prepare the papers and take you through the filing.