Regulatory Escalation · Bima Bharosa

How to File an IRDAI Complaint Online on Bima Bharosa Portal (Step by Step)

When an insurance company wrongfully rejects your health claim, delays settlement beyond 30 days, or ignores your written representation, the Insurance Regulatory and Development Authority of India (IRDAI) provides a direct statutory grievance platform: Bima Bharosa. Here is the step-by-step walkthrough to register, track, and resolve your dispute.

By the MediclaimSaathi team Updated 5 November 20268 min read

Mandatory Pre-Requisites Before Filing on IRDAI Bima Bharosa

Under the IRDAI grievance redressal framework, you cannot approach Bima Bharosa as your very first step. The system is designed as a regulatory escalation watchdog.

Before logging into the portal, ensure you have satisfied the mandatory statutory requirements:

• Prior Written Grievance to Insurer’s GRO: You must first submit a formal written complaint to the Grievance Redressal Officer (GRO) of your insurance company via email or registered portal.
• Expiry of 15-Day Resolution Window: You must either receive a formal rejection letter from the GRO or have waited 15 full days without receiving any resolution from the insurer.
• Gather Key Reference Numbers: Keep your Insurer Grievance Registration Number (Token/Ticket ID), Policy Number, Claim Number, and the exact date of your initial complaint handy.
• Assemble Digital PDF Documents: Prepare clear PDF copies (< 2MB each) of the policy schedule, claim repudiation letter, your written grievance to the insurer, and key medical records.

Step-by-Step Guide: Filing on Bima Bharosa Portal

IRDAI’s Integrated Grievance Management System (IGMS) has been upgraded into Bima Bharosa (bimabharosa.irdai.gov.in), offering policyholders a centralized online redressal window.

1. 1Access Portal & Create AccountVisit https://bimabharosa.irdai.gov.in. Click on "Register Grievance". Enter your Full Name, Mobile Number, and Email ID. Verify your mobile number using the one-time password (OTP) sent to your phone.
2. 2Select Insurer & Policy CategoryUnder "Entity Type", select "Insurance Company". Select "General / Health Insurance", then choose your specific insurer from the dropdown list (e.g., Star Health, Care Health, HDFC ERGO, New India Assurance).
3. 3Provide Policy & Claim IdentifiersEnter your Policy Number, Claim Number, Date of Admission, and Hospital Name. Select the Grievance Type as "Unfair Repudiation of Claim", "Delay in Claim Settlement", or "Short Payment / Proportionate Deduction".
4. 4Furnish Insurer GRO HistoryTick "Yes" for having previously approached the insurer. Enter the Date of Grievance sent to the insurer and the insurer’s internal Token Number. If the insurer did not issue a token, mention "No Token Provided by Insurer Despite Written Email".
5. 5Draft Clear Statement of Facts & Legal GroundsSummarize your dispute in chronological order. Clearly state: (1) Total claim amount; (2) Amount wrongfully deducted/repudiated; (3) Why the rejection violates IRDAI circulars (quote IRDAI May 2024 Master Circular or Regulation 27); (4) Exact relief sought.
6. 6Upload Exhibits & Generate IRDAI TokenUpload your supporting documents (Repudiation Letter, GRO complaint proof, Discharge summary, Doctor certificate). Click "Submit". The system generates an official IRDAI Complaint Token Number (e.g., IRDAI/2026/XXXXX). Save this number for tracking.

Alternative Filing: IRDAI Grievance Call Centre (IGCC)

If you face difficulties navigating the web portal, you can register your grievance telephonically through IRDAI’s dedicated Grievance Call Centre:

• Toll-Free Numbers: Call 155255 or 1800 4254 732 (accessible from anywhere in India, 8:00 AM to 8:00 PM, Monday to Saturday).
• Multilingual Support: Assistance is available in English, Hindi, and major regional languages.
• Direct Email Registration: You can also email your complaint directly to complaints@irdai.gov.in with all attachments. The automated system logs the case into Bima Bharosa and dispatches a tracking token to your email.

What if Bima Bharosa Does Not Resolve: Escalation to Insurance Ombudsman

It is crucial to understand the legal distinction between IRDAI Bima Bharosa and the Insurance Ombudsman:

Bima Bharosa is a regulatory monitoring system. IRDAI forwards your complaint to the insurer’s executive grievance desk and monitors whether they reply within 15 days. IRDAI does not act as a civil judge to pass monetary decrees.

If the insurer reiterates its rejection on Bima Bharosa or fails to settle within 30 days of your initial grievance, your ultimate statutory remedy is the Insurance Ombudsman:

• Governed by the Insurance Ombudsman Rules 2017: Established by the Government of India under the Insurance Act.
• Completely Free: No court fees, no advocates allowed; you represent yourself.
• Claim Limit: Can adjudicate insurance disputes up to ₹50 Lakh.
• Binding on Insurer: An award passed by the Ombudsman is legally binding on the insurance company. If you accept the award, the insurer must comply within 30 days and pay penal interest for any delay.
• 1-Year Limitation: You must approach the Ombudsman within 1 year from the date of the insurer’s final rejection letter.

Costly Mistakes to Avoid During IRDAI Escalation

• Filing on Bima Bharosa Before Approaching the Insurer GRO: IRDAI will close the ticket with a directive to first contact your insurance company.
• Filing in Consumer Court Simultaneously: If you file a case in District Consumer Commission, IRDAI and the Insurance Ombudsman lose legal jurisdiction due to concurrent litigation bars.
• Submitting Vague or Emotional Rants: Focus strictly on dates, policy numbers, medical certificates, and exact IRDAI regulatory violations.
• Not Retaining IRDAI Token Receipts: Always download the PDF acknowledgment of your Bima Bharosa ticket to serve as concrete proof of regulatory escalation before the Ombudsman.

Frequently asked questions