A policyholder's complaint against an insurer that rejected the complaint or did not reply.
Date: 1 April 2026, at Ludhiana
TO:
The Insurance Ombudsman
Office at Chandigarh
COMPLAINANT:
Harjinder Singh Gill
House No. 412, Sector 38-A, Chandigarh 160036
Phone: 98765 43210
Email: harjinder.gill@example.com
AGAINST (the Insurer):
ABC General Insurance Company Limited
Regional Office, SCO 25, Sector 17-E, Chandigarh 160017
SUBJECT: Complaint about policy no. P/141234/01/2026/003318
Sir / Madam,
1.1 The Insurer issued a life insurance policy, number P/141234/01/2026/003318, to Harjinder Singh Gill. The Complainant is the policyholder.
1.2 The amount in dispute is ₹2,50,000 (Rupees Two Lakh Fifty Thousand only).
2.1 My claim for the hospital bills of my wife was made on 12 June 2026. The insurer rejected it on 20 July 2026, saying the illness was pre-existing. The illness first appeared after the policy began.
3.1 On 2 April 2026 the Complainant complained to the Insurer in writing, under reference GRV/2026/04417.
3.2 The Insurer rejected the complaint in writing. The date of the Insurer's reply or rejection is 3 April 2026.
3.3 The Complainant is not satisfied and therefore brings this complaint.
4.1 The Complainant asks the Ombudsman to direct the Insurer to do the following: Pay the hospital claim of the amount stated above, with interest from the date of the claim.
5.1 No court, Consumer Commission or arbitrator is hearing this dispute, and none has decided it.
5.2 This complaint is made within the time the Insurance Ombudsman Rules, 2017 allow, counted from the Insurer's reply or rejection, or from the end of the period for it to reply.
5.3 What is written in this complaint is true to the best of my knowledge, and I have not kept back any fact that matters.
5.4 The Ombudsman's complaint form, filled in, is enclosed with this complaint.
- 1. Policy schedule. 2. My complaint to the insurer dated 1 August 2026. 3. The insurer's rejection letter. 4. Claim papers and bills. 5. Identity proof.
Yours faithfully,
_________________________
Harjinder Singh Gill
Complainant
House No. 412, Sector 38-A, Chandigarh 160036
Date: 1 April 2026