How to Appeal a Rejected Health Insurance Claim in India (2026)
For life policies, Section 45 of the Insurance Act 1938 bars contest after 3 years of continuous coverage except for proven fraud - a powerful lever on older claims.
Step 4: IRDAI Bima Bharosa (IGMS)
File on the Bima Bharosa portal at bimabharosa.irdai.gov.in to put regulatory pressure on the insurer. A trackable reference number is issued and the insurer must respond within 15 days.
Why claims get rejected
Non-disclosure of pre-existing diseases, incomplete waiting periods, policy exclusions, lapsed policies, delayed intimation, and missing documentation cause most rejections. The insurer must state the reason in writing - demand it if absent.
Claim recovery specialists handle appeals through GRO, IRDAI and the Ombudsman, and have recovered over Rs 50 crore for families. See the health insurance claim rejection fight-back guide for free guidance.