Insurance claim rejected? That's not the end. It's our beginning.
InsuranceNyay is the policyholder's legal ally. We take your rejected, delayed or underpaid claim from a lawyer's demand notice all the way to the Insurance Ombudsman, Consumer Court or MACT — and we don't stop until you're paid.
- Free AI case assessment
- Pay mainly on success
- Real lawyers, real courtrooms
₹3.21L Cr
Non-life premiums collected FY25
2,57,790
IRDAI grievances filed FY25
69%
of grievances are about claims
₹26,000 Cr
health claims disallowed FY24
Sources: IRDAI Annual Report FY25 · Bima Bharosa grievance data · Council for Insurance Ombudsmen. The system is failing policyholders at scale — that is why InsuranceNyay exists.
What we fight
Every kind of general insurance dispute
Phase 1 focuses on the three lines that cause 80% of consumer disputes in Gujarat — with travel, crop and commercial lines close behind.
Motor — OD & Theft
Total loss undervalued, theft claims stalled, repairs disputed, surveyor lowballing your vehicle.
Health / Mediclaim
Cashless denied, TPA repudiation, 'pre-existing condition' excuses, short-settled hospital bills.
Property & Fire
Fire and burglary losses cut down by surveyors, under-insurance penalties, exclusion-clause games.
MACT — Accident Victims
Third-party injury and death compensation under the Motor Vehicles Act — structured, no ceiling.
Short Settlements
Paid less than you claimed? Partial payments are contestable — consumer courts award the balance with interest.
Delays & Silence
Claim pending for months? IRDAI timelines are enforceable. We make insurers answer.
How it works
From rejection letter to recovery — four steps
Technology handles intake, triage and tracking. Candour Legal's advocates handle the law. You watch it all happen on your dashboard.
Tell us what happened
Answer a few guided questions and upload your policy, rejection letter and claim papers. Takes under 10 minutes — in English, हिन्दी or ગુજરાતી.
AI reads your case
Claude, our legal intelligence engine, extracts the insurer's rejection ground and tests it against IRDAI PPHI Regulations 2024 and binding case law.
Honest case-strength verdict
You get a Green / Amber / Red score, the recommended forum and the fee — before you pay anything. A Candour Legal lawyer verifies every score.
Lawyers take over
Demand notice in 48 hours. Then IRDAI complaint, Insurance Ombudsman, Consumer Court, MACT or arbitration — real advocates at every hearing, live status on your dashboard.
Service tracks
Three tracks. One goal: your money.
Every case is routed to the fastest forum it qualifies for — and escalated when the insurer won't listen. Transparent fees, stated before you commit.
Notice & Negotiation
₹500 registration + 10–15% success fee
- Legal demand notice within 48 hours
- IRDAI Bima Bharosa (IGMS) complaint
- Insurance Ombudsman (claims up to ₹50 lakh)
- Mediation & Lok Adalat settlement
Fastest route — many claims settle in 15–45 days.
Consumer Court & MACT
₹5,000–15,000 retainer + 15–20% success fee
- District / State / National Consumer Commission
- MACT petitions for motor accident victims
- Evidence, affidavits & expert witnesses
- Execution of awards and decrees
For claims the insurer won't settle — we litigate.
Full Litigation & Arbitration
₹20,000+ retainer + appearance fees
- Commercial court suits for business policies
- Arbitration under commercial policy clauses
- High Court writs against PSU insurers
- Appeals — SCDRC, NCDRC, Supreme Court
Senior counsel for high-value and commercial disputes.
Know your forums
Where insurance claims get fought — and won
The most consequential decision in any dispute is the forum. Our triage engine maps your case to the right one automatically.
| Forum | Limit | Timeline | Cost | Key feature |
|---|---|---|---|---|
| Insurance Ombudsman | Up to ₹50 lakh | ~3 months | Free | Binding on the insurer if you accept the award. |
| IRDAI IGMS / Bima Bharosa | Any amount | 2–4 weeks | Free | Mandatory first step — triggers the insurer's SLA. |
| District Consumer Court (DCDRC) | Up to ₹50 lakh | 6–18 months | Nominal | Awards compensation, interest and costs. |
| State Consumer Court (SCDRC) | ₹50L – ₹2 crore | 1–3 years | Nominal | Original + appellate jurisdiction. |
| NCDRC | Above ₹2 crore | 2–5 years | Higher fee | Apex consumer forum; appeal to Supreme Court. |
| MACT | No ceiling (motor TP) | 1–5 years | Nil for TP | Structured compensation under MVA 1988. |
| Lok Adalat | Consensual settlement | 1 day – 3 months | Free | Award is a decree — instant finality. |
| Civil / Commercial Court & Arbitration | Commercial policies | 6 months – 10 years | Ad valorem | Full litigation track for business policies. |
Why InsuranceNyay
Not an aggregator. Not a chatbot. A law firm with an engine.
We actually litigate
No other claims platform files in consumer courts, MACT and High Courts. We do — with Candour Legal advocates on record.
AI triage before you pay
Claude scores your case against IRDAI regulations and precedent. If your case is weak, we tell you upfront — free.
Gujarat-first, vernacular-first
Gujarati and Hindi interfaces, WhatsApp intake, and deep familiarity with the Ahmedabad Ombudsman and Gujarat consumer courts.
DPDP-grade data protection
Health and financial records encrypted at rest, stored only in India, visible only to your lawyer. Aadhaar never stored.
Straight answers
Frequently asked questions
What should I do if my health insurance claim is rejected in India?
First, get the rejection letter in writing — the insurer must state the exact ground. Under the IRDAI Protection of Policyholders' Interests Regulations 2024, a claim cannot be rejected solely for missing documents or a minor delay in intimation. You can then (1) file a grievance with the insurer's Grievance Redressal Officer, (2) escalate to the IRDAI Bima Bharosa portal, (3) approach the Insurance Ombudsman (free, for claims up to ₹50 lakh), or (4) file a consumer complaint. InsuranceNyay handles all four steps for you, with lawyers from Candour Legal.
Can I go to consumer court for an insurance claim dispute?
Yes. Insurance companies are 'service providers' under the Consumer Protection Act, 2019, and unjustified rejection or delay is a deficiency of service. District Commissions hear claims up to ₹50 lakh, State Commissions up to ₹2 crore, and the NCDRC above that. Consumer courts can award the claim amount plus interest, compensation and costs. The Supreme Court has confirmed that an arbitration clause in your policy does not bar you from consumer court.
What is the Insurance Ombudsman limit?
The Insurance Ombudsman can decide complaints up to ₹50 lakh. It is free, typically takes about 3 months, and the award is binding on the insurer if you accept it. The Ahmedabad Ombudsman covers Gujarat, Dadra & Nagar Haveli and Daman & Diu. Claims above ₹50 lakh must go to the consumer courts or civil courts.
How much does InsuranceNyay charge?
Registration is ₹500 on case acceptance. For notice and Ombudsman work (Track 1) we charge a success fee of 10–15% of the amount actually recovered. Consumer court and MACT matters (Track 2) carry a fixed retainer of ₹5,000–15,000 plus a success component. If we don't think your case is winnable, we tell you before you pay anything — our AI triage and a Candour Legal lawyer review every case first.
How long does it take to recover a rejected insurance claim?
A well-drafted legal demand notice resolves many claims within 15–45 days. Insurance Ombudsman complaints typically conclude in about 3 months. District consumer court matters take 6–18 months. Our triage engine recommends the fastest forum your case qualifies for, and many Track 1 cases settle without any court filing.
Is a MACT claim different from a motor insurance claim?
Yes. Own-damage claims (your vehicle's repair/theft/total loss) are contractual claims against your insurer, fought through the Ombudsman or consumer courts. Third-party injury or death claims go to the Motor Accident Claims Tribunal (MACT) under the Motor Vehicles Act 1988, which awards structured compensation with no monetary ceiling. InsuranceNyay handles both tracks.