ClaimEasyInsurance claim disputes, taken up on your behalf

How a case runs

Six stages, two of which involve money. Nothing here is a surprise later.

  1. Stage 1 Free

    You send the case

    The form on the home page, or a phone call if you would rather talk. We want the insurer's reasoning in their own words — that sentence is usually where the whole dispute sits.

  2. Stage 2 Free

    We read the policy against the rejection

    The wording of the clause relied on, the dates, the proposal form, the medical or surveyor position. Two working days for most files. Then you get a straight answer: arguable, or not arguable.

  3. Stage 3 Registration

    You register the case

    Only for cases we have agreed to take up. You get a case reference, a named person handling it, and the service-fee percentage confirmed in writing before anything is filed.

  4. Stage 4 Included

    We build and file the representation

    The technical response goes to the insurer's grievance redressal officer under your name, with the file arranged in the order they need to read it. The insurer is required to decide within 15 days of receiving it.

  5. Stage 5 Included

    We follow it, and escalate if it stalls

    Reminders on record, then the regulator's portal, then the Insurance Ombudsman if it comes to that. You are told what has moved and what has not — including when nothing has.

  6. Stage 6 Service fee

    The insurer releases the money to you

    Payment comes from the insurer to your account, never through us. Our invoice follows, at the percentage already agreed, on the amount you actually received.

The rungs above a rejection

You can climb every one of these yourself, free. This is what each is for, and what we add.

  1. Rung 1 Insurer must decide within 15 days

    The insurer's grievance redressal officer

    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.

  2. Rung 2 Used when the 15 days pass with no real answer

    IRDAI, through the Bima Bharosa portal

    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.

  3. Rung 3 Within one year of the insurer's reply · free to use

    The Insurance Ombudsman

    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.

  4. Beyond that A lawyer's job, not ours

    Consumer commission or civil court

    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.

Cases we turn down

We decline at the review stage, before you have paid anything, when any of this is true. It is the same list every time, and we tell you which line applies to you.

  • The rejection is correct on the policy wording, and no reading of the facts changes that.
  • Material facts were withheld at the proposal stage and there is no defensible explanation.
  • The claim is outside the policy period, or the cover was never in force.
  • More than a year has passed since the insurer's final reply, closing the Ombudsman route.
  • The documents needed to argue the case no longer exist and cannot be reconstructed.

A turned-down review still comes with our reasoning in writing. Several people have used it to go back to the insurer themselves.

What to keep ready

  • Policy schedule and the full terms booklet
  • The proposal form you signed, if you have it
  • Claim form and the acknowledgement of it
  • The rejection or delay communication
  • Discharge summary and final bill, for health claims
  • Surveyor's report and FIR, for motor and property

Missing something? Say so. Getting a written rejection out of an insurer who has only refused verbally is often the first thing we do for you.

Send your case for review