What to Do If Your Insurance Company Delays Your Claim Settlement

In the world of insurance, time is everything. But what happens when insurance companies delay claim settlement and you're left waiting endlessly—often without updates, clarity, or support?

It’s not just an inconvenience. It’s a serious contributor to insurance claim-related issues, and a common reason why policyholders feel helpless during crucial times.

That’s exactly where Bima Seva Kendra steps in—with the power, empathy, and legal strength to get your voice heard and your claim settled.

 

1. Understanding the Delay in Claim Process

Let’s break it down. What causes a delay in your claim settlement?

Some common reasons include:

• Allegedly “incomplete” documentation (even when everything is submitted)
• Internal mismanagement and high claim volumes
• Intentional delay tactics to avoid full payouts
• Lack of transparency or misleading responses

For most policyholders, these delays create unnecessary emotional stress and financial instability—especially in the case of medical or life insurance claims. Sadly, many give up due to a lack of awareness or professional help.

2. Your Legal Rights as a Policyholder

As per IRDAI regulations, your insurer is bound by the following timelines:

• Claims must be settled within 30 days of the last necessary document’s submission
• If further investigation is required, it must be completed within 90 days
• Once approved, payment must be made within 7 days

Any deviation from this process is grounds for legal escalation, and Bima Seva Kendra can help you take the right steps without the stress or confusion.

3. Case Study: A Real Life Example

Delay in actions regarding such insurance claim-related issues or approaching a Subject Matter Expert can sometimes result in massive losses. Let us take the example of Devendra Bansal v. National Insurance Co.

The Case

The complainant, Devendra Bansal’s Hero Honda motorcycle, insured with National Insurance Co. Ltd. was stolen on July 24, 2009.

He promptly reported the theft, filed an FIR, and submitted all required documents. However, despite repeated reminders, the insurance claim remained unsettled. The insurer later claimed the vehicle had been recovered, but Bansal argued it wasn’t his—pointing out a mismatch in chassis number and extensive damage.

The Argument

Appellant’s (Complainant's) Stand:

• The recovered bike is not his (different chassis number and damaged condition).
• The insurer never physically verified the vehicle and relied solely on an NCRB entry.
• The insurer showed delay in claim process and negligence throughout.

Respondent’s (Insurer's) Stand:

• The vehicle was recovered and the complainant was informed to collect it.
• Since the vehicle was "found", the claim isn’t payable.
• Allegedly the complainant only wanted monetary compensation, not the vehicle.

The Verdict

The Commission held that the delay in claim settlement was unjustified and constituted a deficiency in service. It directed the insurer to settle the claim amount with interest and pay compensation for mental agony and legal expenses.

The above case reinforces that insurance companies must ensure timely claim settlement, and any undue delay without reason is a clear breach of service responsibilities.

4. What You Can Do When Your Claim Is Delayed

Here’s what every policyholder should do the moment they encounter a delay:

1. Document Everything

Keep a record of every call, email, document submission, and response from the insurer. Insurers often cite a lack of follow-up or missing documents as a reason for delays.

2. Submit a Formal Complaint

Raise a structured, written complaint about the insurance company to the Grievance Redressal Officer. Include your policy number, claim details, and a concise explanation of the delay.

3. Escalate the Issue

If there's still no response or resolution, escalate to:

• IRDAI’s Integrated Grievance Management System (IGMS).
• The Subject Matter Experts available.

5. Why You Need Experts Like Bima Seva Kendra

Let’s be real—the insurance industry is complex, with clauses, delays, and fine print that overwhelm most people. That's why more and more policyholders are turning to subject matter experts to avoid insurance claim-related issues.

At Bima Seva Kendra, we offer:

• Claim Rejection Services: If your claim is denied, we analyse the rejection grounds and build a solid appeal.
• Support with Delays: We intervene legally and professionally to fast-track stalled claims.
• Documentation Assistance: We prepare your file so precisely that insurers can't find excuses.
• Legal Escalation: From ombudsman filings to IRDAI escalations, we handle it all.
• Personalised Guidance: Every case is unique—so is our approach.

Bima SEVA Kendra was built on the foundations of restoring “Seva” in the insurance world. With experts that bring 100+ years of collective industry experience, our motive is to serve and be the voice of justice for ALL.

Final Word: Don’t Let a Delay Decide Your Future

Trying to interpret a 40-page policy document to find that fine print causing delays on your own? That’s like being handed a legal contract in another language. And when the stakes are high—your life, your health, your money—guesswork can cost you everything.

That is why at Bima Seva Kendra, we don’t just point out the problem. We fix it. We fight it. And we follow through.

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