Seeking Advice on Delayed Jewelry Theft Claim from Insurance Company
I purchased jewelry from a jeweler that also provided complimentary insurance. Unfortunately, my jewelry was stolen a few months ago, but it was still within the coverage period. I took all the necessary steps—filed a police FIR, obtained an untraceable report, and submitted all required documentation to the insurance company.
On January 31, 2025, I sent in my subrogation form, along with my bank details and PAN card, as requested. The insurance company initially approved my claim. However, after 18 days, they unexpectedly announced that they needed a surveyor to reassess the claim amount, despite having taken subrogation and all my final documents.
The surveyor completed the reassessment but incorrectly reported that I had refused to provide certain documents—documents that he never requested in the first place. When I brought this to the attention of the insurer, they insisted that I hadn’t submitted those documents. I have emails and call recordings confirming that the documents were never requested, but to facilitate the process, I sent them over within a few hours.
Just a few days later, the surveyor officially requested those documents via email—almost a month after being assigned to the reassessment. This situation feels like a deliberate tactic to delay, and I’m concerned that even with my prompt response, they will simply come up with another excuse to stall.
I have a few key questions:
- Can an insurance company deny payment after initially approving a claim and accepting subrogation?
- Are they not violating IRDAI guidelines by delaying payment in this manner?
- What legal or formal actions can I take to compel them to settle my claim?
Any advice would be greatly appreciated. Has anyone else experienced similar tactics from insurance companies?
I’m sorry to hear about the challenges you’re facing with your insurance claim. Navigating the claims process can often feel frustrating and overwhelming, especially when dealing with delays. Here are some responses to your key questions and suggestions on how to proceed:
Generally, once an insurance claim is approved and subrogation has taken place, the insurer is legally obligated to honor that claim. It’s unusual (and potentially improper) for an insurer to retract approval unless they discover new evidence that fundamentally alters the circumstances of the claim. Since you have documented proof of their initial approval, it strengthens your position that they should fulfill their obligation.
Aren’t they violating IRDAI guidelines by delaying payment this way?
Yes, insurance companies in India are governed by the Insurance Regulatory and Development Authority of India (IRDAI) guidelines, which mandate timely resolution of claims. If the insurer is unnecessarily delaying your claim without adequate justification, they may be violating these guidelines. Documenting these delays is crucial if you decide to escalate the matter.
What legal or formal steps can I take to force them to settle the claim?
It’s advisable to act swiftly, as delays can sometimes hinder your ability to pursue your claim effectively. Document every interaction with the insurer and keep a record of all communication. This information will be invaluable should you need to take formal action. Best of luck, and I hope for a prompt resolution to your claim!