Insurance Grievances
Something doesn't feel right? Know what you can do.
Insurance problems aren’t always about a rejected claim. You may have been sold a policy under misleading terms, promised something the policy doesn’t provide, or found yourself dealing with an issue that hasn’t been resolved despite raising it with the insurer.
The first step is knowing what went wrong. The next is knowing what you can do about it.
This hub covers common insurance grievances, from mis-selling and policies presented as fixed deposits to the different channels available when a complaint remains unresolved. Use the guides to understand the problem, work out where you stand, and find the appropriate next step.
Insurance Mis-selling
Were you sold insurance without being told what you were actually buying?
Buying a policy should involve a clear explanation of what the product is, what it covers, what it costs, and what conditions apply. But that’s not always how a sale is presented.
Mis-selling can happen when a policy is presented inaccurately, important information is withheld, risks or conditions are downplayed, or an insurance product is made to sound like something it isn’t. The problem may only become apparent later, when you read the policy more carefully or try to use it.
These guides can help you recognise common forms of insurance mis-selling and understand what you can do if you believe a policy was sold to you under misleading terms.
Recognise the warning signs →
What Is Insurance Mis-selling?
Insurance mis-selling happens when a policy is sold using false, misleading or incomplete information, or when the product recommended is unsuitable for the customer’s needs. The problem may not always be obvious at the time of purchase. A policyholder may only realise something was wrong when they review the policy, try to surrender it, make a claim or discover that the benefits differ from what was promised.
Mis-selling can take several forms. An agent may describe an insurance policy as a fixed deposit or guaranteed savings product, make return promises that are not supported by the policy, leave out important exclusions or waiting periods, or pressure someone into signing without giving them enough time to review the documents.
It can also involve incorrect information being entered in the proposal form or additional riders being added without clear consent. Whether the misrepresentation was deliberate or resulted from poor advice, the policyholder can be left with cover that does not match their expectations or financial needs.
A clear understanding of insurance mis-selling helps you recognise warning signs early. You learn to identify when you may have grounds to question or challenge the sale of a policy.
Policy Sold as FD
A policy sold as a fixed deposit (FD) is a common form of insurance mis-selling. It happens when an insurance policy is presented as a safe, one-time deposit or guaranteed-return scheme, leading the buyer to believe they are opening an FD. The difference may only become clear later, when another premium is due or the documents reveal terms such as “sum assured”, “policy term” and “premium”.
An FD and an insurance policy serve different purposes. An FD involves placing a lump sum with a bank, post office or NBFC for a specified tenure and interest rate. Insurance involves paying a premium in exchange for protection, and some policies may also provide maturity or other benefits.
If you expected an FD, check who issued the product, whether you were asked to make recurring payments and whether the documents mention an insurer, a bank or other deposit-taking institution.
Knowing how to identify a policy sold as an FD helps you spot mis-selling early and take appropriate action, including using the free-look period or raising a formal complaint when necessary.
Escalation Pathways
Insurance-related issues not resolved? Know where to take your complaint next.
Raising a complaint with your insurer is an important first step, but it may not always resolve the issue. If you’re dissatisfied with the response, haven’t received a resolution, or believe your concern needs to go further, additional channels are available.
The right route can depend on the nature of your complaint and where you are in the grievance process. That’s why it helps to understand the escalation path before simply moving from one channel to another.
These guides take you through the different options, starting with the insurer and moving through the available external grievance and dispute-resolution mechanisms.
Escalation Guide
An insurance complaint does not always end with the insurer’s first response. You may have grounds to escalate if a claim is delayed or rejected without a satisfactory explanation, promised benefits are not paid, policy terms were misrepresented, or you face unresolved servicing and documentation issues. The same applies when premiums are deducted incorrectly, a policy is changed without clear consent, or there is a dispute over coverage or exclusions.
The usual route begins with the insurer’s Grievance Redressal Officer (GRO). If the issue is not resolved satisfactorily, you can approach IRDAI through Bima Bharosa. Depending on the circumstances, the Insurance Ombudsman may be the next forum, particularly where the insurer has not responded within the required period, or its final response remains unsatisfactory.
If these avenues do not resolve the dispute, consumer or other legal remedies may be considered. Policy documents, complaint reference numbers, correspondence, claim records and the insurer’s response throughout the process hence become important to keep.
When you are aware of the escalation path, you can raise your complaint with the right authority. You can preserve important evidence and avoid missing the applicable timelines.
Insurance Ombudsman Guide
The Insurance Ombudsman provides policyholders with a formal way to resolve certain disputes with an insurer when the insurer’s own grievance process has not provided a satisfactory outcome. The mechanism is designed to be accessible and cost-effective, covering issues such as claim rejection or delay, premium disputes, policy terms, servicing problems and mis-selling. It is a quasi-judicial grievance forum, so understanding its eligibility rules and process matters before filing.
You generally need to approach the insurer first and give it an opportunity to resolve the complaint. If there is no response within the applicable period or the response is unsatisfactory, you may be able to approach the Ombudsman, subject to the scheme’s jurisdiction and filing conditions. Policy document, your original complaint, the insurer’s response or rejection letter, premium records and other relevant correspondence are crucial here.
The Ombudsman may first facilitate a settlement between the parties. If that does not resolve the dispute, the Ombudsman may issue an award under the applicable rules.
The right information on how the Insurance Ombudsman works helps you determine whether your dispute qualifies, prepare the right documents and choose the appropriate route for resolution.
IRDAI Bima Bharosa Platform
IRDAI’s Bima Bharosa platform provides a formal channel for policyholders who have already raised a complaint with their insurer but remain dissatisfied with the response or have not received one within the prescribed period. It allows grievances to be registered and tracked, while bringing the matter within the insurance regulator’s grievance-monitoring framework. Issues may include delayed or rejected claims, mis-selling, incorrect policy servicing, premium discrepancies or concerns about how the insurer has handled a complaint.
Before filing, keep your policy number, insurer details and previous grievance reference number ready. Supporting documents such as the policy schedule, claim or rejection letter, premium receipts, emails and other relevant correspondence can help establish what happened.
When submitting the complaint, it is important to explain the issue clearly, mention the steps already taken with the insurer and state the resolution you are seeking. Once registered, the complaint number allows you to track its progress and refer to it in future communication. If the response remains unsatisfactory, other grievance or dispute-resolution options may still be available.
Once you understand how Bima Bharosa works, you can escalate an unresolved insurance complaint with the right records. You can also maintain a clear trail of the action taken.
Consumer Court Guide
A consumer court, formally called a Consumer Disputes Redressal Commission, can provide a legal route when an insurance dispute remains unresolved. Policyholders may approach the consumer commission for issues such as unfair claim rejection or underpayment, prolonged delays, mis-selling, incorrect policy servicing or other deficiencies in service. Depending on the case and evidence, the commission can direct an insurer to pay a claim, refund premiums, provide compensation or cover certain costs.
Before filing, it is important to build a clear record of the dispute. Keep the policy document, premium receipts, claim form, rejection or settlement letter, correspondence with the insurer and any other evidence supporting your case. Complaints generally need to be filed within two years of the cause of action.
However, a delay may be condoned in appropriate circumstances. The appropriate commission depends on the value of the dispute, and complaints can be filed online or through the relevant commission. A consumer court is one possible route alongside other grievance mechanisms, but the same dispute should not be pursued simultaneously through competing forums.
A clear view of the consumer court process enables you to assess when legal action is appropriate and how you should approach it.