Health insurance claim rejected? You can still fight it.
Answer a few questions and see your deadline, your route, and the regulator's rules that apply to your case. It is free. If you want the letters written for you, the full pack costs ₹999.
Check my claim, freeTakes about 3 minutes. No sign-up. Your answers stay on your device.
A rejection letter is not the last word
There is a set route, in a set order. Most people stop at the first step because nobody tells them the rest.
Your insurer
Write to the grievance officer. Insurers must acknowledge at once and resolve within 14 days.
IRDAI
Not resolved? Complain on Bima Bharosa, or call 155255. It is free.
Insurance Ombudsman
After a reply you disagree with, or a month of silence. You have one year. An award is due within three months of the Ombudsman having everything needed from you.
Consumer commission
A backup. Go here first and you lose the Ombudsman route on the same subject.
What is free, and what the pack adds
Free check
- Your deadlines, worked out from your dates
- Where you are on the route, and what to do next
- The rules that apply to the reason you were given
- The Ombudsman office that covers you
- Mistakes that can close off your options
Claim pack
- Letter to your insurer's grievance officer
- IRDAI Bima Bharosa complaint text
- Ombudsman complaint, covering what Rule 14 asks for
- Field-by-field guide to the Ombudsman portal
- Checklist of documents for your reason
- Hearing script and settlement notes
- Calendar reminders, plus Word and PDF downloads
₹999 one time, taxes included
Refund within 7 days if it does not help.
Rejection reasons we cover
- Non-disclosure
- Pre-existing disease
- Waiting period
- Hospitalisation not needed
- Treatment excluded
- Late intimation
- Missing documents
- Room rent and other deductions
- Suspected fraud
- Cashless refused
- No decision yet
- Policy lapsed
- Multiple policies
- Employer group cover
What the letters sound like
Firm and factual, and built on the regulator's own words. Here is one paragraph from a letter for a non-disclosure rejection.
This policy has been in continuous force for more than 60 months. Chapter I, para 13 of the Master Circular says no policy and claim of health insurance shall be contestable on any grounds of non-disclosure and/or misrepresentation except for established fraud, after completion of the Moratorium Period of 60 months of continuous coverage. The insurer has not established fraud, so this ground is not open to it.
Fair questions
Is filing with the Ombudsman really free?
Yes. Filing with your insurer, with IRDAI's Bima Bharosa and with the Insurance Ombudsman costs nothing. If someone asks you for a processing fee to file with the Ombudsman, be careful. Our ₹999 is for the drafting help and nothing else, and you can do all of it yourself without us.
Can't I just ask ChatGPT?
You can, and it may give you a decent letter. Check its rule references and dates against the sources we list, because a wrong citation weakens your complaint. What we add is rules read directly from the source, deadlines worked out from your dates, and a guide that follows the Ombudsman portal's own fields.
Will I get my money?
Nobody can honestly promise that. IRDAI reports that nearly 79% of Ombudsman cases decided in FY26 went in favour of policyholders, but that is the whole system's figure, not a prediction for your case. Some rejections are correct under the policy. Our free check will show you what you can argue.
Are you lawyers?
No. Healthouts is a self-help tool. You file in your own name, which is what Rule 14 of the Ombudsman Rules provides for. If your case involves police, a court case or more than ₹50 lakh, please speak to a lawyer.
Where do my details go?
Your case details stay in your browser. They are not sent to our servers, and we keep no database of customers' cases. When you pay, Razorpay handles the payment and sees what any payment provider sees. Read the privacy page for the detail.
Which claims does this cover?
Health insurance claims in India on individual, family and employer or group policies. It is not for life or motor insurance, government schemes like CGHS or PM-JAY, disputes above ₹50 lakh, or matters already in court.
What if it does not help me?
Email us within 7 days of paying with your payment ID and you get a full refund. There are no questions and no form to fill.
Who is behind this
Healthouts began in 2013 as an online doctor consultation service, founded by Sheshakanth Munagapati in Hyderabad. This tool is its new chapter. A rejected claim is largely a paperwork fight with a deadline, and getting the paperwork right is something a small, careful team can do well. Every rule we cite is listed on our sources page so you can check it yourself.