Insurance complaints in India surged from 684 in Q1 to 974 by Q2 of 2025 — a 45% increase. The value of such claims rose from Rs 83.5 crores to Rs 119.5 crores, a 43% jump. Health insurance alone accounts for 68% of all complaints. The system is under strain, and policyholders are paying the price.

The Problem with Traditional Channels

Consumer commissions typically take 6 months to 2 years to resolve insurance disputes. For a policyholder dealing with a denied health claim during a medical emergency, that timeline is simply unacceptable. The process is adversarial, expensive, and emotionally draining.

IRDAI 2025 Reforms

• Revised guidelines on pre-existing conditions and moratorium periods.
• Stronger oversight of Third Party Administrators (TPAs) handling claims.
• Encouragement of technology-driven grievance redressal mechanisms.
• Push for faster resolution timelines across the insurance industry.

How ODR Changes the Game

ODR platforms can resolve insurance disputes in 45 to 90 days — a fraction of the time taken by consumer commissions. The process is virtual, confidential, and produces enforceable outcomes. For health insurance disputes, where every day of delay can mean financial hardship, ODR is not just convenient — it is essential.

When your health insurance claim is denied, you shouldn’t have to wait two years for justice.

Platforms like Sammat are bridging the gap between policyholders and insurers, offering a structured, neutral process that resolves disputes fairly and quickly. With IRDAI’s 2025 reforms creating a more supportive regulatory environment, ODR is poised to become the default channel for insurance grievance resolution.