Define the insurance problem and the result you need

Write one sentence that identifies the policy or claim issue and one sentence stating the remedy requested. Examples include reconsidering a rejected treatment authorization, correcting a no-claims record, explaining a motor-claim valuation, paying an approved amount or fixing incorrect policy data. A broad statement that the company is unfair is harder to investigate than a dated disputed decision.

Confirm that the organization is an insurance company or another party within the insurance relationship supervised by the Insurance Authority. A hospital billing dispute, traffic accident-percentage objection, employer-benefit issue or bank complaint can require a different first channel even when insurance is involved. Separate those records and complain to the party responsible for the decision you are challenging.

Build a small, complete evidence file

Collect the policy schedule and wording, claim or authorization number, insurer decision, invoices, medical or accident reports relevant to the issue, payment evidence and previous messages. Make a dated timeline with the submission, each request for more information and each response. Use file names that identify the document and date so that an investigator can follow the sequence.

Include only records needed for the complaint. Medical files, Iqama copies, bank details, vehicle documents and family information are sensitive. Upload them only through the insurer's or Authority's official secure channel. Redact unrelated details from a supporting screenshot, but keep the original available if the case handler requests it. Never post a rejected-claim letter publicly with readable member, policy or QR information.

Complain to the insurer before escalating

Use the company's official complaint channel, not only an agent's chat or a call with no reference. State the policy or claim reference, the disputed decision, the date, the evidence attached and the requested resolution. Ask for a formal complaint number and the applicable response period. If more information is requested, send it through the same case and note when the requirements became complete.

The Insurance Authority stated in its April 2025 complaints-index announcement that a beneficiary may escalate when the complaint remains unresolved or the company fails to respond within five business days after all requirements are met. Some Authority notices concerning particular suspended companies have used a three-business-day period. Follow the period given for your insurer and case; do not treat an exceptional notice as the rule for every company.

  1. 1

    Open a formal insurer complaint

    Use the insurer's published channel and obtain a complaint number rather than relying only on an informal conversation.

  2. 2

    Complete the requirements

    Submit the relevant evidence and record when the company confirmed that the complaint file was complete.

  3. 3

    Save the answer or missed deadline

    Keep the final response, unresolved point or proof that the stated response time passed.

Escalate through the Insurance Authority

The Insurance Authority's electronic service allows an insured person or another party involved in the insurance relationship to raise a complaint without visiting its headquarters. Open the official Complaint against an insurance company service, sign in through the National Access portal (Nafath), select Submit a Complaint and enter the case information requested by the live form.

Provide the insurer's complaint reference, a concise account of what remains unresolved, the remedy requested and the documents that support it. Check that names and numbers match the policy. Save the Authority reference after submission. Escalation asks the regulator to follow the complaint; it does not guarantee a particular payment, medical approval, repair value or legal finding.

Follow the case and respond to requests

Check the complaint through the official portal and respond promptly if the Authority or company asks for clarification. Answer the exact question and refer to the document that supports the answer. If a call is received, verify that the caller can identify the case through information already in the official portal; do not disclose an OTP or approve an unrelated Nafath request.

When a resolution is offered, check every practical part: the amount and payment date, corrected record, treatment authorization, repair instruction or written reason. Do not close the complaint only because a verbal promise was made. Keep the final decision and proof of implementation together. If the issue is still disputed, use the review or further-rights information shown in the official decision rather than assuming another identical complaint will reopen it.

Protect urgent rights while the complaint is reviewed

A complaint does not pause every medical, traffic, repair, court or contractual deadline. For urgent treatment, ask the provider and insurer what immediate route applies and seek emergency care when clinically necessary. For a damaged vehicle, preserve inspection, storage and repair records and follow safety instructions. For a cancellation or renewal dispute, check the policy dates separately.

The Authority publishes its contact page and complaint entry point, including the toll-free number 8001240551 when this guide was verified. Confirm contact details on ia.gov.sa before using them. If the online record is unavailable, contact the Authority with the existing complaint reference and exact error. Avoid claims-management agents who demand an upfront transfer or promise a guaranteed regulatory decision.