What Is Delay in Insurance Claim? – Complete Guide
A delay in insurance claim occurs when an insurance company does not settle or process a valid claim within the time limit prescribed by the IRDAI (Insurance Regulatory and Development Authority of India). Such delays can cause financial stress, especially during medical emergencies, accidents, or death claims.
Insurance companies are legally required to process claims within defined timelines, and unjustified delays can be challenged.
IRDAI Timelines for Insurance Claim Settlement
As per IRDAI guidelines:
- Claim acknowledgment: Immediately or within 3–7 days
- Investigation (if required): Must be completed within 30 days
- Claim settlement or rejection: Within 30 days after receiving all documents
- Interest payable: If delay occurs beyond timelines, insurers may have to pay interest
Common Reasons for Delay in Insurance Claims
Insurance claims may get delayed due to:
- Incomplete or incorrect documents
- Delay in submission of claim intimation
- Investigation by insurer
- Discrepancy in policy details
- Non-disclosure or mismatch of information
- High claim volume with insurer
Types of Insurance Claims Where Delays Are Common
- Health Insurance Claims (cashless & reimbursement)
- Life Insurance Death Claims
- Motor Insurance Claims
- Property & Fire Insurance Claims
What to Do If Your Insurance Claim Is Delayed
Step 1: Contact the Insurance Company
- Follow up with customer care or claims department
- Ask for written status update
Step 2: Submit Pending Documents
- Ensure all required documents are submitted
- Keep acknowledgment proof
Step 3: Raise a Written Grievance
- File a complaint with the insurer’s grievance cell
- Mention policy number, claim number, and delay duration
Step 4: File Complaint with IRDAI
- Lodge complaint on IRDAI Integrated Grievance Management System (IGMS)
- Upload all supporting documents
Step 5: Approach Insurance Ombudsman
- If delay is unjustified and unresolved
- Free and consumer-friendly dispute resolution
Rights of Policyholders in Case of Claim Delay
- Right to timely claim settlement
- Right to written explanation for delay
- Right to interest on delayed claims (in eligible cases)
- Right to approach IRDAI and Insurance Ombudsman
How to Avoid Delay in Insurance Claims
- Inform insurer immediately after claim event
- Provide complete and accurate documents
- Keep policy active and updated
- Ensure correct nominee and personal details
- Maintain copies of all records
Conclusion
A delay in insurance claim can cause unnecessary hardship, but policyholders are protected by IRDAI regulations. Knowing your rights, following up properly, and using grievance mechanisms can help ensure faster claim settlement.
At Saving Mantra, we assist policyholders in resolving delayed insurance claims, grievance filing, and claim follow-ups to ensure fair and timely outcomes.
Disclaimer
This blog is for informational purposes only and does not constitute legal, financial, or insurance advice. Claim timelines, interest eligibility, and dispute resolution depend on policy terms and IRDAI regulations. Readers are advised to consult qualified insurance professionals or legal experts for specific cases.