Your claim is pending, with no decision
How to find out where a claim is stuck, how to follow up in writing, and when a grievance is the next step.
What this situation means
A delay usually means one of three things: the insurer is waiting for something, the file is with someone who has not acted on it, or a query went out and did not reach you. Finding out which one it is changes what you should do.
The most common cause, by some distance, is a query that the claimant did not see — sent to an old email address, caught in spam, or given to the hospital rather than to you. Before treating a delay as inaction, it is worth confirming that nothing is pending at your end.
Your policy wording and the insurer's own grievance policy set out the timelines that apply to your claim. Those are the timelines to rely on, rather than a general figure heard elsewhere.
What to check first
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Whether a query is pending
Ask in writing whether anything is awaited from you. Check your spam folder and any alternative email address on the policy.
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The registered contact details
Confirm the email address and mobile number recorded against the policy are the ones you actually use.
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What the insurer acknowledged
Find the claim intimation reference and the acknowledgement of your submission. A claim that was never logged cannot move.
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Whether the hospital sent everything
For cashless, papers often travel through the hospital desk. Ask what was sent and when.
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The applicable timeline
Read the claims procedure in your own policy wording and the grievance procedure published by your insurer.
What to keep
- The claim intimation reference and the date of intimation
- Proof of every document submitted, with the covering email and acknowledgement
- A dated log of every follow-up: when you wrote, to whom, and what came back
- A note of every phone call, with the date, the name given and what was said
- The policy wording section dealing with claims and grievances
How to write to your insurer
- Send a short, factual follow-up on the existing thread, with the claim number in the subject. State the date of submission, what has been sent, and ask for the current status.
- Ask directly whether anything is awaited from you. That single question resolves a surprising number of delays.
- Keep the tone even. A file that is simply sitting moves faster with a clear summary than with a complaint.
- If there is still no response, write to the insurer's grievance officer following the procedure published in the policy wording and on the insurer's website. Attach the correspondence so far.
- If a call is made to you about the delay, follow it up the same day with an email recording what was said and by when action was promised.
A written record helps you keep track of what was asked, what you submitted and what was communicated. The claim guide has the email templates.
How ClaimSaathi can help
We can help you prepare the follow-up, work out whether anything is genuinely pending at your end, and prepare grievance or escalation correspondence where appropriate. We do not contact the insurer on your behalf and we do not promise a decision by any date.
Need help with your claim?
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