Claim rejected? Find out exactly why
A rejection letter usually gives one reason and a clause number, and leaves you to work out the rest. Share the letter, and your policy if you have it, and TellBrief tells you the reason in plain words, the clause it relies on, and the steps to challenge it, in order.
What TellBrief tells you
- The reason for rejection in plain words, and the clause it cites
- Whether it's a waiting period, an exclusion, a missing document or non-disclosure
- How to appeal: the insurer's grievance team, Bima Bharosa, then the Ombudsman
- The documents worth sending with your appeal
Words you'll see
- Waiting period
- A time after the policy starts during which some illnesses aren't covered.
- Exclusion
- Something the policy never covers, listed in the policy wording.
- Non-disclosure
- When the insurer says something was not declared when the policy was bought.
- Bima Bharosa
- IRDAI's grievance portal, for complaints the insurer hasn't resolved.
- Insurance Ombudsman
- A free forum for disputes. You can go to it if the insurer rejects your complaint or doesn't reply within 30 days, within a year.
Questions
Can a rejected claim be challenged?
Yes. Start with the insurer's grievance officer in writing. If that doesn't resolve it, you can complain on Bima Bharosa and then to the Insurance Ombudsman.
Will TellBrief tell me if the rejection is wrong?
It shows the reason and the clause side by side, so you can see whether they match. It doesn't decide the dispute.
Can it read my policy too?
Yes. Brief the policy as well, then ask, for example, "Does clause 4.2 really exclude this?"
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General information, not legal, medical or financial advice.
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