When an insurer rejects or sits on a genuine claim, most policyholders give up because the reply is written in policy language they were never given a chance to argue with. We read your file, find the clause the rejection actually turns on, and take it back to the insurer as a technical case.
Nothing is payable until we have read your file and told you the case is worth pursuing. We reply within 2 working days.
Rejected Repudiated Condition treated as pre-existing, though the waiting period had already run and no such condition appears in the proposal form.
Representation filed with the grievance cell · day 11
Settled ₹4,20,000 released in full, with the repudiation withdrawn.
An illustration of how a file moves, not a real customer's case.
Three moments, no others. There is no consultation charge, no monthly retainer, and no fee on money you have not received.
Whether the rejection is arguable, on what ground, and what it will take. If we think you will lose, we say so.
Charged only for cases we have agreed to take up. Covers drafting the representation and corresponding with the insurer as long as the case runs.
A share of what actually reaches your account. The percentage is fixed in writing before anything is filed.
If the claim is not recovered, there is no service fee — the ₹500 registration is all you will have spent. On a ₹4,00,000 claim settled in full, the fee works out between ₹40,000 and ₹60,000.
A claims processor's rejection is the first word, not the last. There are three rungs above it, and every one of them is open to you free of charge — with or without us.
Every insurer has a grievance cell that sits above the claims department. A rejection from a claims processor is not the company's final position, and this is the rung where most disputes are actually won.
What we do here. We write the representation: the exact clause relied on, why it does not apply to your facts, the treating doctor's or surveyor's position, and the precedent where one exists. Sent under your name, with the file attached in the order they need to read it.
The regulator does not decide your claim, but a complaint logged here is tracked and the insurer has to respond to it on record. Silence stops being an option.
What we do here. We log it, keep the reference alive, and follow up in writing so the file does not go quiet. Most delayed cases move at this point without going further.
An independent forum whose award binds the insurer. It handles personal-lines claims up to a prescribed limit, and you must have approached the insurer first. No lawyer is needed and there is no fee.
What we do here. We prepare the complaint and the annexures, and brief you for the hearing — which is usually a short, plain conversation, not a cross-examination.
A small number of cases need a court. We do not appear in court and we will not pretend otherwise.
What we do here. We hand over the complete file, organised, with our written analysis — so your advocate is not starting from a shoebox of bills.
Personal and small-business lines. Under each is the reasoning insurers most often rely on, and each of those is arguable on the right facts.
Cashless denials, post-hospitalisation bills, room-rent capping and disease waiting periods.
Death claim repudiations, mostly turning on what the proposal form did or did not ask.
Surveyor deductions, total loss valuation, and claims closed as no-claim.
Disability percentage disputes and accident-versus-illness classification.
Overseas medical claims, trip cancellation and baggage loss.
Fire, burglary and business interruption claims, including underinsurance deductions.
It is charged only after we have read your file and told you we think the case is worth pursuing. It covers opening the case, drafting the technical representation, and corresponding with the insurer on your behalf. It is not refundable, because the work starts immediately.
You pay us nothing further. Our service fee is a share of money actually received by you, so if nothing is recovered there is no fee. You are out the ₹500 and nothing else.
Between 10% and 15% of the amount the insurer releases to you. The exact percentage is agreed in writing before we file anything, and it is charged only after the money reaches your account.
Insurers are required to decide a grievance within 15 days of receiving it. In practice a straightforward health or motor case is often resolved in three to six weeks. If it has to go to the Insurance Ombudsman, expect a few months.
Yes, and we will tell you when you should. The insurer's grievance cell, the IRDAI Bima Bharosa portal and the Insurance Ombudsman are all free to use. People come to us when the rejection turns on a clause or a medical point they cannot argue on their own.
No. If the rejection is correct on the policy terms, or the claim involves misrepresentation we cannot defend, we say so at the review stage and charge you nothing. Taking a hopeless case would waste your money and our time.
The policy document, the claim form you submitted, the insurer's rejection or delay communication, and the bills or reports relevant to the claim. If the rejection is verbal or only on an app, tell us — getting it in writing is usually the first thing we do.
Yes. Agents and intermediaries refer disputed claims to us regularly. You stay in the loop on the case, and your client keeps dealing with you for their policy. Details are on the partners page.
Fill this in once. We read it, and either tell you where the rejection is weak, or tell you honestly that it isn't.
Useful to have ready
You don't need to upload anything now. If we take the case up, we'll ask for exactly what's needed and nothing more.