How to Check an Insurer's Complaint Record Before You Buy

A written reply tabled in the Rajya Sabha this month put insurer-wise policyholder complaint data for April–June 2026 into the public domain. It is a useful moment to build a habit that most buyers never develop: looking up an insurer's grievance and claims record before signing, rather than discovering it during a claim.

This is an educational walkthrough of what that data shows, why the headline numbers are easy to misread, and where to find the two figures worth checking.

What the Q1 FY27 Complaint Data Shows

Insurers received 80,539 policyholder complaints during Q1 FY27, of which 73,143 were attended to and 7,396 remained pending. The category breakdown is where the useful signal sits.

Two observations follow directly:

• Claims alone accounted for close to 46 per cent of all complaints in the quarter. The moment of truth in any policy is the claim, and that is where grievances concentrate.
• Unfair business practices, the category that captures mis-selling, ranked third with 8,503 complaints. That is a complaint about how the product was sold, not how it performed.

The annual picture is larger. Across FY26, insurers received 2,97,468 complaints through the Bima Bharosa portal and disposed of 2,87,496, leaving 9,972 pending. Life insurers accounted for 1,19,027 of those, health insurers 1,17,979 and other non-life insurers 60,462.

Why Raw Complaint Counts Mislead

Here is the trap. When this data is reported, the insurer at the top of the list looks like the worst performer. It usually is not.

The largest life insurer in the country recorded the highest complaint count in Q1 FY27 — which is not unexpected given it has the biggest customer base and agent network. The source data carries this caveat explicitly: complaint figures do not account for differences in customer base, policy count or business size.

A raw count is a numerator without a denominator. To make it mean something:

• Scale it. Complaints per lakh policies in force, or per crore of premium, is the comparable figure. An insurer with ten times the policyholders will generate roughly ten times the complaints at identical service quality.
• Look at disposal, not just receipt. In Q1 FY27 several life insurers closed every complaint they received during the quarter, while others carried a substantial pending balance — one private life insurer had 478 of 635 complaints still pending, and among public sector general insurers, United India Insurance reported 1,068 pending and Oriental Insurance 891. The pending-to-received ratio is a far better behavioural signal than the headline count.
• Read the category mix. An insurer whose complaints cluster in policy servicing has a different problem from one whose complaints cluster in claims.

None of this makes any single insurer good or bad. It makes the number usable.

The Two Numbers Worth Looking Up

1. Complaint volume and resolution rate

Where: Bima Bharosa, IRDAI's integrated grievance portal, plus periodic Parliamentary replies and the grievance section of the IRDAI Annual Report.

What it measures: how many policyholders escalated a grievance formally, in what category, and how many the insurer closed.

What it does not measure: the severity of each grievance, or dissatisfaction that never got escalated. Many policyholders simply give up rather than file.

Bima Bharosa is also where you would register your own complaint later. IRDAI has required insurers to acknowledge complaints immediately and resolve them within 14 days, with technology-based grievance systems integrated into the portal, a 12-language call centre, and monitoring through MIS reports, periodic reviews and on-site inspections.

2. Claim settlement ratio

Where: the IRDAI Annual Report, laid before Parliament under Section 20 of the IRDA Act, 1999, and the accompanying Handbook on Indian Insurance Statistics, which carries the insurer-wise tables.

What it measures: the share of claims an insurer settled in a financial year against claims available for disposal.

What it does not measure: how long settlement took, why claims were repudiated, or how the policy's own terms shaped the outcome. A ratio computed on a few hundred claims is also statistically weaker than the same ratio on several lakh.

A practical caution: figures circulating on comparison sites are frequently stale or drawn from different financial years and different methodologies. Trace any number back to the IRDAI table and check which year it covers before relying on it.

Why Claims Get Rejected — and What That Tells a Buyer

IRDAI's own analysis of repudiation found health claims are mainly rejected for non-compliance with policy terms, exhaustion of the sum insured, misrepresentation, non-disclosure or fraud, and hospitalisation that is not medically necessary or does not meet minimum duration requirements. Partial settlement typically arises when a claim exceeds the sum insured or sub-limits, or from co-payment, deductibles, room-rent limits and non-medical expenses.

Read that list again. Most of those causes are not the insurer behaving arbitrarily — they are the policy wording doing exactly what it says, meeting a buyer who never read it.

That reframes the due diligence:

• Disclose fully at proposal stage. Non-disclosure of medical history or occupation is a recurring cause of disputes years later.
• Read the sub-limits, not just the sum insured. A Rs. 10 lakh cover with a room-rent cap can behave like a much smaller one.
• Check waiting periods for pre-existing conditions and specified illnesses, which run from policy inception.
• Keep claim documentation organised from the first hospitalisation onward.

Fitting This Into a Buying Checklist

Complaint and claims data is one input among several. A reasonable sequence for someone evaluating a policy:

1. Size the cover first. Adequacy of the sum insured or sum assured for the household comes before any insurer comparison. The Term Insurance Calculator works through the income-replacement calculation.
2. Read the policy wording — exclusions, waiting periods, sub-limits, co-payment, network hospitals in your city.
3. Check the insurer's claims record in the IRDAI Annual Report for the relevant financial year.
4. Check the grievance record, weighting the disposal rate and category mix over the raw count.
5. Disclose everything at proposal stage.
6. Revisit at renewal, since cover adequacy and terms both drift. The Money Moves tools cover several of these periodic review calculations.

The suitability of any insurance product depends on an individual's financial circumstances, dependants, health profile, existing cover and objectives.

Key Takeaways

• Insurer-wise complaint and claims data is public in India, and most buyers never look at it.
• Claims drove roughly 46 per cent of all insurance complaints in Q1 FY27; mis-selling ranked third.
• Raw complaint counts favour smaller insurers optically — always weigh against customer base size.
• The disposal rate and pending balance are more informative behavioural signals than the headline count.
• Claim settlement ratio (IRDAI Annual Report) and complaint resolution (Bima Bharosa) are complementary, not interchangeable.
• Most health claim rejections trace back to policy terms the buyer did not read, or disclosures the buyer did not make.

Where to Start

Pick the one insurance policy in your household you understand least — usually a health or endowment policy bought years ago through a relationship you no longer remember. Look up the insurer's grievance and claims data for the latest published year, then read that policy's exclusions and sub-limits alongside it.

The exercise takes an evening. It is considerably cheaper than discovering the same information during a claim.

Insurance products are regulated by IRDAI and are distributed subject to applicable licensing. Cover amounts, waiting periods, exclusions, sub-limits and claim conditions are governed by the individual policy wording. Please read the policy document carefully before concluding a sale.

Complaint and claim settlement data referenced above relates to specified past periods, is published by IRDAI and in Parliamentary replies, and does not indicate or predict the future service quality, claim outcome or grievance handling of any insurer. Nothing in this article ranks, endorses, recommends or disparages any insurance company or product.

Mutual Fund investments are subject to market risks. Please read all scheme-related documents carefully before investing. Past performance may or may not be sustained in the future.

The suitability of any insurance product or investment category depends on an individual's financial goals, risk appetite, investment horizon and overall financial circumstances. Nothing in this article constitutes a recommendation to buy, sell or hold any specific product.

Meta Investment is an AMFI-registered Mutual Fund Distributor (ARN-129322) and not a SEBI-registered Investment Adviser. If investments are made through a mutual fund distributor, the distributor may receive commissions from Asset Management Companies. Such commissions should not influence suitability-based recommendations. See our commission disclosure for details.

Regulatory figures, portal features and timelines cited above should be independently verified against current IRDAI sources, as they are subject to change.

This communication is intended solely for educational and informational purposes and should not be construed as investment advice, a recommendation, or a solicitation to buy or sell any financial product.

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