Insurance Claims Assistance
Help with insurance claims — documentation, follow-up, partial or rejected claims, Bima Bharosa grievances and the Insurance Ombudsman.
- Estimate Cost
- ₹5,000 – ₹50,000
- Typical duration
- 30 days
Service overview
Insurance claims assistance helps you get a fair and timely settlement from your insurer. WCP professionals manage documentation, insurer and surveyor coordination, follow-ups and disputes for health, motor, property, life and business claims.
Who needs it? / When is it needed?
- Policyholders and nominees facing hospitalisation, accidents, theft, property damage or a death claim.
- When a claim is delayed, partly settled or rejected.
- When y
What to expect from the WCP Professionals
- Review of the policy terms and claim eligibility.
- Claim intimation, form filling and document checklist.
- Coordination with the insurer, TPA, surveyor and hospital.
- Regular follow-ups and negotiation on deductions.
- Escalation to the insurer's grievance cell, Bima Bharosa portal or Insurance Ombudsman if needed.
Key deliverables
- Claim file with complete documentation.
- Status updates until settlement.
- Written representations or appeals for disputed claims.
- Settlement summary explaining any deductions.
Standard turnaround time
- Claim filing: 1–3 working days after documents are received.
- Settlement: insurers generally settle within 30 days of the last required document; complex or disputed claims can take 1–3 months.
- Ombudsman matters: usually 3–6 months.
Government fees, timelines & key outcomes
- No government fee for claim filing or Insurance Ombudsman complaints.
- Insurer grievances can be escalated to the Ombudsman if unresolved after 30 days, within one year of the insurer's reply.
- Key outcome: maximum eligible claim amount received with minimum stress.
Forms & filings involved
- Insurer or TPA claim form.
- Cashless pre-authorisation request (health).
- Surveyor report and FIR (motor and property).
- Grievance or Ombudsman complaint form, if needed.
Documents required
- Policy copy and claim intimation number.
- Bills, receipts, discharge summary and reports (health).
- FIR, RC, driving licence and repair estimates (motor).
- Death certificate, nominee KYC and bank details (life).
What we need from you
- Prompt intimation of the loss to the WCP professional and to the insurer.
- Original documents and accurate facts.
- Availability for surveyor visits and insurer queries.
Important conditions
- Late intimation, non-disclosure or policy exclusions can lead to rejection.
- The final settlement decision rests with the insurer or the Ombudsman.
- Do not dispose of damaged property before the survey.
Additional information
- Keep copies of every document submitted to the insurer.
- IRDAI rules set time limits for cashless approvals and claim settlement.
- Related services: Insurance Renewal & Premium Management, Legal Notice drafting.
The estimated cost covers indicative professional fees only. Government fees, stamp duty and taxes are payable at actuals.
How it works
- 1. Raise a service enquiry describing your requirement.
- 2. A Relationship Manager reviews it and opens it for bidding.
- 3. Pay into escrow and assign the professional you select.
- 4. Track progress to completion, then accept and release payment.
Frequently asked questions
What can I do if my claim is rejected?
Ask for written reasons, complain to the insurer's grievance officer, escalate via Bima Bharosa, then approach the Insurance Ombudsman or a Consumer Commission.
What claims can the Insurance Ombudsman hear?
Complaints up to ₹50 lakh against insurers, free of cost, after first approaching the insurer.
How long does an insurer have to settle a claim?
IRDAI rules set time limits for claim decisions and payment, with interest payable for delay.
What documents are usually needed?
Claim form, policy, identity proof, bills and reports, FIR where relevant, and bank details.