Can insurance company reject my claim unfairly?

No. Insurance companies must give reasons for rejection in writing. You can appeal to Insurance Ombudsman or file a consumer complaint.

An insurance company cannot reject a valid claim without proper justification. Under the Insurance Act, the insurer must provide written reasons for rejecting a claim. Common unfair practices include: rejecting claims on technical grounds, delaying settlements beyond reasonable time, offering lower amounts than due, and citing exclusions not clearly mentioned in the policy. If your claim is rejected: first file a grievance with the insurer's grievance cell, then approach the Insurance Ombudsman through the IGMS portal (igms.irda.gov.in) for claims up to ₹30 lakhs, or file a consumer complaint for higher amounts. The Ombudsman's decision is binding on the insurer. Keep all policy documents, hospital bills, communication records, and claim documents as evidence.

• Insurance Act — Section 45 (Policy not to be questioned after 3 years)
• IRDA regulations on claim settlement
• Consumer Protection Act