Insurance Claim Letter

To, The Claims Department [insurer_name], [branch_office] Date: [claim_date] Subject: Claim under policy no. [policy_number] — [claim_type] Sir/Madam, 1. POLICY PARTICULARS Policyholder : [policyholder_name] Policy number : [policy_number] Type of claim : [claim_type] Date of incident : [incident_date] 2. PARTICULARS OF THE INCIDENT [incident_details] 3. AMOUNT CLAIMED Rs. [claim_amount], as supported by the documents enclosed. 4. I confirm that the policy was in force on the date of the incident, that all premiums due had been paid, and that the loss falls within the cover granted. 5. DOCUMENTS ENCLOSED [documents_enclosed] 6. I request that the claim be registered, a claim number be allotted to me in writing, and a surveyor be appointed where one is required. 7. Kindly inform me promptly of any further document or information required, so that it can be furnished without delay. I request that the claim be settled within the period prescribed under the applicable IRDAI regulations. Yours faithfully, [policyholder_name] Policy: [policy_number] Contact: [contact_number] ACKNOWLEDGMENT Claim registered on ______________ Claim No. ______________ ──────────────────────────────────────────────────────────────── DELAY IN INTIMATION IS THE COMMONEST REASON CLAIMS ARE REFUSED Not fraud, not exclusions — delay. Most policies require the insurer to be informed within a short window of the incident, often twenty-four to forty-eight hours for motor and theft claims and a few days for health admissions. A claim that is otherwise perfectly good gets repudiated because nobody told the insurer in time. INTIMATE FIRST, DOCUMENT LATER. Telephone or email the insurer the day it happens, get a claim number, and send the paperwork afterwards. The intimation is what preserves the claim; the documents can follow. WHERE A POLICE COMPLAINT IS REQUIRED — theft, accident, fire — lodge it immediately and quote the FIR number in the intimation. An insurer is entitled to ask why a theft was reported to them but not to the police. IF THE CLAIM IS REJECTED: 1. Ask for the rejection IN WRITING with reasons. An oral refusal is not something you can act on. 2. Escalate to the insurer's GRIEVANCE REDRESSAL OFFICER — every insurer must have one, and the details must be published. 3. Then to the INSURANCE OMBUDSMAN, which is free and does not require a lawyer. Complain within the period prescribed under the Insurance Ombudsman Rules. 4. A repudiated claim is also a "deficiency in service" actionable before a Consumer Commission under the Consumer Protection Act, 2019 — but choose one forum, not both. KEEP EVERYTHING. Photographs taken at the time, the original bills, the claim form you submitted, and every email. Insurers decide on the file in front of them.