You did everything right. You paid the premium for years. The claim event happens — and the insurer mails you a one-page denial citing a clause you never knew existed. We dismantle that denial.
Most claim denials cite vague grounds — “non-disclosure of material fact”, “pre-existing disease”, “policy lapsed”, “claim time-barred” — written in a way that sounds final and unappealable. They are almost never as final as they sound. The IRDAI obliges insurers to provide specific, evidence-backed reasoning for every denial, and most rejection letters fail this test.
Our first step is to demand the full claim file under IRDAI’s disclosure norms — the investigator’s report, the medical reviewer’s notes, the underwriter’s original assessment. Almost invariably, the file reveals weaknesses in the denial: contradictions, missing documents, mis-applied clauses. We build our appeal around these weaknesses with surgical precision.
We obtain the investigator's report and medical reviewer's notes — usually never shared with the policyholder.
A clause-by-clause rebuttal citing IRDAI circulars, Supreme Court precedent, and policy wording in your favour.
Original claim amount paid in full — with interest in cases of unreasonable delay.
An audit-ready file of all submissions, so any future claim on the same policy is bulletproof.
Send us the denial letter and policy schedule. Within 48 hours we tell you whether — and how — the denial is appealable.
We file an information request under IRDAI norms to get the insurer's full case file — investigator notes, medical reviewer notes, underwriting decision.
We submit a structured rebuttal to the insurer's Grievance Officer, then escalate to the IRDAI Ombudsman within 30 days if unresolved.
Claim paid into your account. Our success fee is deducted only after credit is confirmed.
Send us the denial letter or short-settlement note. We will tell you within 48 hours whether — and how — we can recover it.