IRDAI Claim Turnaround Time Rules

One common worry among policyholders is how long a claim will take to settle. To protect consumers, IRDAI sets out turnaround time norms that guide insurers on how promptly they must process claims. This guide explains the idea behind these timelines, the broad expectations they set, and what you can do if an insurer is slow.

What Turnaround Time Means

Turnaround time, often shortened to TAT, is the period within which an insurer is expected to complete a defined action, such as deciding on a claim or releasing payment after approval. IRDAI frames these norms so that consumers are not left waiting indefinitely and so that the industry maintains service discipline.

Why These Rules Exist

• Consumer protection: They prevent unreasonable delays during difficult times.
• Accountability: Insurers must act within defined windows, not at their leisure.
• Predictability: Policyholders get a reasonable sense of how long things should take.
• Fair treatment: Delays beyond norms can attract interest or scrutiny.

Broad Stages a Claim Passes Through

Typical flow

• Intimation and registration of the claim.
• Submission and verification of documents.
• Assessment, which may include a survey or investigation for complex cases.
• Decision to approve, query or repudiate.
• Payment of the approved amount, generally by NEFT.

Turnaround norms apply across these stages so that each step moves within a reasonable period.

Health and Cashless Claims

For cashless health claims, regulators expect insurers and their administrators to respond to pre-authorisation requests and discharge approvals quickly, since patients are waiting at the hospital. Prompt handling of pre-authorisation and final approval is central to a good cashless experience.

What Affects the Actual Timeline

• Completeness of documents: Missing papers are the most common cause of delay.
• Need for investigation: Complex or high-value claims may take longer.
• Clarity of information: Inconsistent details can trigger queries.
• Responsiveness: How quickly you reply to insurer requests matters.

If Your Claim Is Delayed

Steps you can take

• Confirm that all documents have been submitted and acknowledged.
• Follow up using your claim reference number through the helpline or app.
• Escalate to the insurer's grievance redressal officer in writing.
• Lodge a complaint on the IRDAI grievance portal, Bima Bharosa, if needed.

Where settlement is delayed beyond norms after approval, insurers may be required to pay interest, so it is worth keeping records.

Conclusion

IRDAI turnaround norms exist so that claims move within reasonable timeframes and policyholders are treated fairly. Submitting complete documents and following up promptly are the best ways to keep your own claim on track. When comparing insurers, look at their claim service reputation and settlement record, and seek the view of a trusted advisor on TruePolicy.