Health insurance claims: How to ensure grievance redressal

My health insurer recently rejected my claim, citing my inability to provide key internal hospital papers that they require. Despite having submitted all other necessary documents, they are insisting on these specific papers, which I am unable to obtain from the hospital. I believe my claim is valid and that I have complied with all the necessary documentation required.

- Shilpa Arora

What are my options to ensure that my grievance is handled fairly and my claim is reconsidered? -Name withheld on request

If your health insurance claim has been rejected due to a lack of documentation, it's very crucial to understand your rights and the protections available under the latest guidelines set by the Insurance Regulatory and Development Authority of India (IRDAI).

The guidelines are designed to promote transparency in the claims process, simplify documentation requirements, and ensure greater protection for policyholders. Specifically, emphasizing that claims must not be unfairly rejected or closed due to missing documents or delays in notifying the insurer.