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Have you been denied a rightful insurance claim? Misled by an agent? Or discovered your policy has hidden terms that were never disclosed? If yes, it may be time to file an official insurance fraud complaint.

In India, there are clear legal pathways to file grievances against insurance companies, and this guide will walk you through them—step by step.

What Is an Insurance Fraud Complaint?

An insurance fraud complaint refers to an official grievance lodged by a policyholder when an insurance company or its agents engage in deceptive practices, including:

False assurances during policy sale denial of genuine claims without proper reason tampered policy documents or forged signatures unauthorized issuance of policies Non-disclosure of critical terms and exclusions

If you've faced any of these, you're entitled to raise your voice through India’s regulatory framework.

Step 1: File a Complaint with the Insurance Company

As per IRDAI (Insurance Regulatory and Development Authority of India) guidelines, your first step must be to report the issue directly to the insurer.

Here's How to Do It:

Lodge a complaint through the insurer’s Grievance Redressal Portal

Email the Grievance Redressal Officer (GRO) – details are listed on every insurer’s official website

Visit the nearest branch and submit a signed written complaint

Keep a copy of the acknowledgment or complaint number. As per IRDAI norms, the insurer must resolve the complaint within 15 days.

Step 2: Escalate via IRDAI – IGMS Portal

If the insurer fails to respond within the timeframe or gives an unsatisfactory reply, escalate the matter by filing an insurance fraud complaint with IRDAI.

Use the Integrated Grievance Management System (IGMS): https://igms.irda.gov.in

Toll-Free Numbers: 155255 or 1800 4254 732 Email: complaints@irdai.gov.in

Attach:

The original complaint reference number Policy documents and supporting evidence A clear description of the issue

IRDAI will monitor the case and follow up with the insurer.

Step 3: Approach the Insurance Ombudsman

If your complaint is still unresolved or unfairly rejected, you can approach the Insurance Ombudsman—an independent authority that handles consumer insurance disputes for free.

Key Details:

You must have first raised the complaint with the insurer

The complaint must be filed within 1 year of the insurer’s final response The Ombudsman’s decision is binding on insurers

How to File:

Visit https://cioins.co.in Locate your regional office

File online or send a written application with all supporting documents

Step 4: Legal Action (if necessary)

If the Ombudsman cannot resolve the issue, or if you're dealing with criminal fraud such as forgery or unauthorized policy issuance, you can take legal action:

File a case with the Consumer Forum

Lodge an FIR at your local police station (in cases of fraud or identity misuse) Approach a civil court for recovery or compensation if the claim value is high

Real Challenges Faced by Consumers

Common triggers for insurance fraud complaints include:

Claim denials due to hidden exclusions Fake or unauthorized policy issuance

Pressure sales by bank agents (bancassurance) Disputes over claim amounts in motor and health policies

The good news: India’s legal system and insurance regulations are built to protect you—as long as you take action.

Final Thoughts: Take Control of Your Rights

If you've experienced fraud, delays, or unfair treatment by an insurer, don’t stay silent. Filing an insurance fraud complaint is your right—and often the only way to get justice and prevent future misconduct.

Quick Checklist:

Keep all records: policy docs, emails, bills, call logs File your first complaint with the insurer

Escalate via IGMS if needed

Approach the Ombudsman or courts if unresolved

Share Your Story

Have you filed an insurance fraud complaint in India recently?

Tell us your experience in the comments—or reach out to our team if you’d like your story to help others navigate their claims.

This article is part of our Consumer Protection India series. Follow us for more on financial literacy, insurance rights, and dispute resolution.