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If your insurance company has rejected your claim, or paid only part of it, your first written complaint goes to that company’s grievance department. Below is a sample complaint letter: fill in the yellow boxes, then copy it, share it, print it, or save it as a Word file or PDF.
When to use this letter
- Your claim was rejected in full (insurers call this “repudiation”).
- Only part of the claim was paid and the rest was cut.
- The rejection letter gives no clear reason, or you believe the reason is wrong.
It works for life, health, motor, home or any other policy, and a nominee claiming after the policyholder’s death can use it too. For the full path after the insurer — IRDAI’s Bima Bharosa portal and the Insurance Ombudsman — see our guide Insurance Claim Rejected? What to Do and How to Complain.
Keep these ready before you write
- The rejection letter or email — it has the claim number, the date and the reason given.
- Your policy document — the policy number and the policy wording (the terms and exclusions). Read the clause the insurer quoted.
- Your claim papers — bills, discharge summary, death certificate, FIR or survey report, whichever apply.
- Proof for your side — for example a doctor’s certificate, older medical reports, or emails with the insurer.
Sample letter — fill it in
Complaint letter to insurance company for claim rejection
Tap a yellow blank to fill in your details. What you type stays on your phone; nothing is saved by us. Close this tab when you are done.
The Grievance Officer,
Date:
Subject: Complaint against rejection of claim no. under policy no.
Dear Sir/Madam,
I am the under the above policy. I made a claim of Rs. for .
By your letter dated , the claim was rejected / paid only in part. The reason given was: .
I do not agree with this decision because .
I request you to:
1. Review my claim again and settle it as per the terms and conditions of the policy.
2. If you do not accept my request, give me your decision in writing with the reasons and the specific policy terms and conditions you rely on.
3. Acknowledge this complaint and give me the complaint reference number.
If my complaint is not resolved, I may approach the Insurance Ombudsman.
I enclose copies of: .
Yours faithfully,
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This is only a sample. Change it to fit your situation.
How to send it
Under Section VI of IRDAI’s Master Circular on Protection of Policyholders’ Interests (5 September 2024), you can lodge a complaint with the insurer in any of these ways:
- Hand a printed copy at the nearest branch — get your own copy signed, dated and stamped as received.
- Send it by post — keep the Speed Post or Registered Post receipt.
- Email it to the insurer’s grievance email address — you can paste the letter into the email body; keep the sent email.
- Submit it in the grievance / complaint section of the insurer’s website.
The grievance email and address are usually in your policy document and on the “Grievance Redressal” page of the insurer’s official website. You can also register the complaint on IRDAI’s Bima Bharosa portal. Whichever way you choose, keep proof of the date you complained — the time limits below start from that date.
What happens after you send it
| When | What should happen | Rule |
|---|---|---|
| As soon as the complaint is received | The insurer gives you an acknowledgement | IRDAI Master Circular 2024, Section VI-2(i) |
| Within 14 days | The insurer resolves the complaint, or gives reasons for not accepting it with specific reference to the policy terms and conditions | Same circular, Section VI-2(i) |
| If you are not satisfied with the reply, or get no reply within one month of the insurer receiving your complaint | You can complain to the Insurance Ombudsman, free of charge, for claims up to ₹50 lakh | Insurance Ombudsman Rules 2017, Rule 14(3); circular Section VI-3 |
| Time limit for the Ombudsman | Within one year of the insurer’s final reply, or of the end of that one-month period if there was no reply | Ombudsman Rules 2017, Rule 14(3)(b) |
Rule 14(3) says the Ombudsman takes a complaint only after you have first complained to the insurer in writing — by letter, email or the insurer’s website. That is why this letter, and proof that you sent it, matter.
What IRDAI rules say about rejecting a claim
- Life insurance: an insurer must not reject a claim without legally tenable evidence for the rejection. (Circular, life section, page 107)
- Health insurance: when a claim is rejected or partly disallowed, the claimant must be told the full details, with reference to the specific terms and conditions of the policy. A rejection also needs the approval of the insurer’s Product Management Committee (PMC), or of the PMC’s three-member Claims Review Committee (CRC). (Circular, health section, page 121)
- Retail general insurance (motor, home and so on): a claim cannot be rejected, fully or partly, for breaking a condition that has nothing to do with how the loss happened, or for a delay by you that did not increase the loss. (Circular, general section, page 134)
If one of these applies to your case, you can mention it in your own words in the “Why you disagree” box. This is information about the rules only; the outcome of your claim depends on your policy terms and your evidence.
An example (imaginary)
Suresh from Guntur (name and details imaginary) claims a ₹62,000 hospital bill on his health policy. Company X pays ₹41,000 and cuts ₹21,000, writing only “as per policy terms”, with no clause named.
| Date | What happens |
|---|---|
| 03-11-2026 | Suresh fills in the letter above and emails it to the grievance address with the rejection letter and bills. An auto-reply with a complaint number arrives the same day. |
| By 17-11-2026 | The 14-day period ends. By now the insurer should resolve it or give reasons that name the policy clause. |
| After 03-12-2026 | If there is still no reply after one month, Suresh can go to the Ombudsman. The one-year limit runs from 03-12-2026, when that month ends (not from the day he complained), so up to 03-12-2027. |
These dates and amounts are only to show how the timeline works. In your case, count from the date you complained.
Words you will see
| Word | Plain meaning |
|---|---|
| Grievance Officer | The person at the insurer who handles complaints |
| Repudiation | Rejecting a claim in full |
| Partial settlement | Paying only part of a claim |
| Acknowledgement | The insurer’s receipt or reference number showing it got your complaint |
| Policy wording | The part of the policy with all the terms, conditions and exclusions |
| Insurance Ombudsman | An independent officer who hears unresolved complaints free of charge; the Hyderabad office covers Andhra Pradesh and Telangana |
Check before you send
- Do the policy and claim numbers match the rejection letter?
- Have you read the reason (and the clause, if named) in your own policy wording?
- Is every point in “Why you disagree” true and backed by a document you have attached?
- Are you sending copies, not originals?
- Have you kept proof of the date you complained (receipt, sent email or complaint number)?
- Have you noted the 14-day and one-month dates?
This is a sample letter, not legal advice. Change it to fit your situation.
Sources
- IRDAI Master Circular on Protection of Policyholders’ Interests, 05-09-2024 (Ref IRDAI/PP&GR/CIR/MISC/117/9/2024): Section VI (Complaints Mechanism) — ways to complain, immediate acknowledgement, resolution with reasons in 14 days, Ombudsman up to ₹50 lakh (pages 110–111); life claim rejection (page 107); health claim rejection (page 121); general claim rejection (page 134)
- Insurance Ombudsman Rules, 2017 (Council for Insurance Ombudsmen copy): Rule 14(3) — written complaint to the insurer first, one-month and one-year limits
- IRDAI Bima Bharosa portal
- Council for Insurance Ombudsmen — online complaint
All sources checked on 25 October 2026. Last updated: 25 October 2026.