Answer

1. F

   Facts

   Insurance claim rejection is the worst financial surprise a family faces. 5-8% of life insurance claims are rejected. Most rejections cite "non-disclosure" or "misrepresentation." But many rejections are wrong or disproportionate. Every rejection can be contested, at the insurer level, then IRDAI ombudsman, then consumer court. Know the process.

2. P

   Provisions and law

   • Insurance Act Sec 45
3. A

   Analysis

   Top 5 reasons insurers reject life insurance claims: (1) Non-disclosure of pre-existing disease at time of proposal. (2) Misrepresentation: occupation, income, lifestyle habits (smoking, alcohol) under-declared. (3) Policy lapsed, premium not paid and grace period expired. (4) Claim within exclusion period (suicide within 1 year, adventure sports without rider). (5) Fraudulent claim, staged death or fake documents. Section 45, the 3-year rule is your strongest weapon: If policy is more than 3 years old from date of risk inception (not issue date): insurer CANNOT reject on grounds of non-disclosure or misrepresentation. Section 45 is absolute. Many wrongful rejections on 4-5 year old policies are legally invalid. Insurer knows this, a CA-backed legal notice citing Section 45 often results in quick settlement.

4. C

   Conclusion

   1. 1Get rejection letter in writing, insurer must give written grounds, not just verbal
   2. 2Read exactly which clause is cited: non-disclosure / PED / lapse / exclusion / fraud
   3. 3Check policy inception date vs claim date: if > 3 years, invoke Section 45 immediately
   4. 4For non-disclosure claims: check if condition was actually disclosed (re-read proposal form)
   5. 5Write to Grievance Officer (CEO level) of insurer, registered post with acknowledgement
   6. 6File complaint on IRDAI Bima Bharosa: bimabharosa.irdai.gov.in, free, 15-day resolution target

General guidance from TaxSavvy’s library of money processes. Laws change; your Savvy confirms the answer on your exact case before anything is filed.