CLAIMVOICE • CLAIM PROBLEM GUIDE

Something is wrong
with my claim.

Don't start with “Who should I complain to?” Start by identifying exactly what has gone wrong. A delay, a rejection, a low settlement and a request for more documents are different problems and need different responses.

First rule: keep the paper trail. Save the claim number, intimation date, survey/inspection details, documents submitted, emails/messages, calls or call references, estimates, bills and every settlement/rejection communication. If the insurer asks for something, understand exactly what is being requested and why before responding.

What exactly is the problem?

Choose the closest match. You may have more than one problem at the same time.

01 • REJECTION / REPUDIATION

“Your claim is rejected.” What does that actually mean?

A rejection is not a complete explanation by itself. The important question is: what precise fact, condition, exclusion or other reason is the insurer relying upon? Ask for the decision in writing and identify the policy clause cited.

Check these six things

  1. Is the rejection written?
  2. What exact reason is stated?
  3. What exact policy wording/clause is cited?
  4. What facts/evidence does the insurer say support it?
  5. Did the insurer consider your documents/explanation?
  6. What is the insurer's grievance route?
Example

“Claim rejected because keys were missing” is not enough for a policyholder to understand the decision. The useful next question is: which policy condition is being applied, what facts were considered, and what evidence is missing?

Do not create a new story merely to overcome the objection. Respond to the actual issue with truthful evidence.

Useful response: “Please provide the detailed written grounds of repudiation/rejection, the specific policy clause relied upon, and the documents/facts considered in arriving at the decision.”
02 • DELAY

“It is under process.” How do you find out what is actually pending?

“Under process” is a status, not a useful explanation. A good follow-up asks which stage is pending, since when, with whom, and what—if anything—is required from you.

Survey pending

Ask whether an inspection has been assigned and whether the vehicle has been inspected.

Documents pending

Ask for a complete list rather than responding to repeated individual requests without context.

Investigation pending

Ask what stage the investigation has reached and whether any clarification is required from you.

Assessment pending

Ask whether the repair estimate/assessment has been completed and what remains.

Approval pending

Ask whether the claim is otherwise admitted and only authorisation/payment remains.

Payment pending

Ask for payment approval date, amount, deductions and expected payment status.

Example timeline

Claim intimated 3 June → vehicle inspected 5 June → documents submitted 8 June → no update by 25 June. Instead of repeatedly asking “any update?”, send one written message listing the dates and asking which stage is pending, what action is required from you, and the next expected milestone.

03 • PARTIAL SETTLEMENT / LOW PAYMENT

The insurer paid less than you expected

Do not compare the workshop estimate directly with the bank payment and assume the difference is unexplained. First reconstruct the calculation.

Repair / assessed loss₹ ______
Less depreciation₹ ______
Less compulsory/voluntary excess₹ ______
Less non-covered items₹ ______
Less other applicable deductions₹ ______
Net settlement₹ ______

The exact heads depend on the policy, claim facts and settlement method. Some add-ons may change treatment of particular deductions. Ask for the insurer's calculation rather than guessing.

Example: Workshop estimate ₹1,50,000; insurer pays ₹1,05,000. The right question is not simply “Why did you cut ₹45,000?” Ask for an itemised assessment showing accepted parts/labour, depreciation, excess, excluded items and any other deduction.
04 • DEDUCTIONS

Every deduction should have a name and a reason

Depreciation

Reduction applied to eligible parts under applicable policy terms. Do not confuse it with a general “claim penalty.”

Deductible / Excess

The portion of an admissible loss that the insured must bear under the policy.

Non-covered item

An item or expense may fall outside the insured coverage or applicable policy conditions.

Salvage

Value attributed to damaged/replaced property retained or dealt with under the settlement terms.

Betterment

Where applicable, a charge may arise where replacement improves the position beyond the pre-loss condition. The exact treatment depends on policy/assessment.

Add-on treatment

Zero depreciation, consumables, tyre, engine or other add-ons can change what is payable, but only within their wording and limits.

Ask for: an item-wise assessment/settlement calculation, the policy basis for each material deduction, and clarification of any amount you cannot reconcile.
05 • SURVEYOR / INSPECTION

When the survey or inspection becomes the problem

Common situations

  • Surveyor not appointed.
  • Appointment made but inspection is not happening.
  • Inspection completed but assessment is unclear.
  • Surveyor says a part is not payable.
  • Workshop and surveyor disagree on repairs.
  • You are told to wait for the report with no useful status.

What to record

  • Name and contact details provided by the insurer.
  • Date/time of inspection.
  • Vehicle location.
  • Photographs/documents requested.
  • Major points of disagreement.
  • Any written assessment or estimate.
Example: If the workshop says the rear panel needs replacement but the assessment allows repair, ask for the assessment item and the technical basis for the difference. Keep the workshop estimate and photographs. Do not turn a technical disagreement into a personal argument.
06 • INVESTIGATION PENDING

Investigation can be legitimate—but “investigation pending” should not become a permanent black box

Investigations may examine the circumstances of loss, documents, ownership, cause, timing or consistency of evidence. The policyholder should cooperate truthfully while keeping a record of what has been requested and supplied.

Keep a request log

Date requested → document/question → date supplied → proof of submission → response.

This simple table can reveal whether the file is actually moving.

Example: If the insurer requests a document already supplied, resend it with the original submission date and attach the earlier proof. Ask them to confirm whether anything else remains outstanding.
Privacy principle: Do not provide passwords, OTPs, banking login credentials or unrelated private information merely because someone asks for it. If a sensitive document is genuinely required, ask what it is required for and use the insurer's official channel.
07 • ADDITIONAL DOCUMENTS REQUESTED

More documents are requested after you thought everything was complete

An additional request is not automatically improper. Sometimes a missing fact genuinely needs support. The practical problem is an unclear or endlessly expanding request.

AskWhat exact document is required?
WhyWhat part of the claim does it establish?
PolicyIs there a policy/claim-process basis?
FormatCopy, original, certified copy or digital?
DeadlineBy when is it required?
Already supplied?If yes, give the earlier submission date.
Example: If financial records are requested, do not automatically assume they are either necessary or unnecessary. Ask the insurer to specify the purpose, scope and period required and how the information relates to the claim. Provide only what is legitimately required through an official channel, subject to the policy/process and applicable law.
08 • CLAIM CLOSED

Your claim is marked “closed” but you do not know why

“Closed” is not self-explanatory. Find out whether the claim was paid, rejected, withdrawn, closed for non-response, closed after settlement, or closed for another stated reason.

09 • NO RESPONSE

Calls are happening, but nothing is moving

Convert a phone conversation into a written record. After a call, send a short email: “As discussed today, my understanding is…” This creates a timeline without turning every interaction into a confrontation.

Better than: “Nobody is helping me.”
Use: “Claim no. ___ was intimated on ___. Documents were submitted on ___. I request confirmation of the current pending stage, outstanding requirements, and the next action/date.”
10 • PAYMENT NOT RECEIVED

Approved does not always answer every payment question

If a settlement has been communicated, check the approved amount, deductions, payee details, payment date/reference and whether any lender/financier process affects payment.

Amount

Does the settlement letter match the amount credited?

Date

When was payment authorised or initiated?

Reference

Is there a transaction/UTR/payment reference?

Payee

Who was the payment made to?

Finance

Does the vehicle have a financier/hypothecation arrangement?

Deduction

Can every material deduction be reconciled?

11 • POLICY CONDITION / EXCLUSION

When the insurer says “policy does not cover this”

Ask for the exact wording. “Not covered” can refer to an exclusion, a condition, an uninsured item, an add-on limit, a deductible or another policy mechanism. These are not interchangeable.

Practical test: Write down the insurer's reason in one sentence. Then find the cited clause in your policy. Compare the facts of your case with the words of the clause. If you cannot understand the clause, use the ClaimVoice Policy Decoder rather than guessing.
12 • OTHER DISPUTES

Licence, permit, late intimation, previous damage and other objections

Licence issue

Check the actual licence status/category and the facts at the time of the incident. Do not alter records.

Permit issue

Relevant mainly where the vehicle/use requires a permit. Ask for the exact objection and applicable policy/legal basis.

Late intimation

Explain the actual reason for delay and provide evidence where available. Do not invent an emergency.

Previous damage

Separate old marks from the new loss. Whole-vehicle photographs can help establish context.

Non-disclosure

Ask exactly what information is alleged to have been withheld and how it affects the claim.

Insurable interest

Ownership/financial interest in the insured vehicle can matter. Use the Policy Decoder for the concept and evidence.

The ClaimVoice Problem-Solving Ladder

1Identify the exact problem
2Collect the timeline
3Collect the evidence
4Read the relevant policy clause
5Ask a precise written question
6Check the response and calculation
7Escalate if unresolved

Escalation should be a step in the journey—not the first answer to every problem. First make the dispute precise enough that another person can understand exactly what happened.

Check the relevant policy term Escalation & Help →