After two years of decline, policyholder complaints against Indian insurers jumped 18% in 2025, hitting 2.3 lakh cases, data from the Insurance Regulatory and Development Authority of India (IRDAI) shows.
1. Claim Settlements Delayed Beyond Deadline
In 34% of cases reported last year, policyholders waited more than 30 days beyond the IRDAI’s 30-day settlement deadline. Delhi’s Rupesh Kumar, 42, is still fighting for ₹7.2 lakh in car insurance after 150 days. “The insurer keeps transferring me from desk to desk,” he said this month. The finance category has sharp analysis of claim disputes nationwide.
2. Rejections Without Proper Explanation
Another 29% of complainants alleged claims were rejected without clear reasons. Mumbai’s Reena Verma, 38, received a letter dismissing her ₹4.6 lakh health insurance simply as “pre-existing condition.” She is now pressing the Consumer Forum after discovering the insurer never asked for her old hospital records before issuance. And medical files show no prior hospitalisation.
3. Mis-Selling Life Insurance as Investment
Surprisingly, 18% of complaints involved agents pushing life policies as guaranteed return products. Bangalore’s tech professional Arjun Nair, 29, said an LIC agent convinced him his ₹12,000 annual premium would mature at ₹2.4 lakh in 2030. Instead, Arjun will receive ₹1.36 lakh. The agent now faces a debarment notice from IRDAI.
4. Health Insurers Refusing Pre-Hospitalisation Cost
Did you know most health plans refuse to reimburse diagnostic tests taken before hospital admission? 11% of health insurance cases relate to this clause. Chennai’s Lakshmi Reddy, 62, was denied ₹12,800 in blood tests. Her lawyer pointed out the Supreme Court’s 2023 ruling that pre-hospitalisation costs are part of overall treatment.
5. Non-Renewal Notices Sent Mid-Policy
Even your own insurer can betray you mid-year. 8% of complaints allege non-renewal or premium hikes were disclosed just two weeks before policy expiry. Jaipur’s retired schoolteacher Shanta Devi, 67, received such a notice for her ₹5 lakh family health plan. Her current insurer cited “rising claims ratio,” yet the same policy was sold online at 15% lower premium to new buyers.
If you face delayed claims, appeal to IRDAI within 18 months. For mis-selling, lodge a complaint within 45 days on IGMS portal and attach policy documents. And always opt for policies with 30-day free look-in period—you can cancel within those days for a full refund.
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