Your health or life insurance document enumerates the terms and conditions of the policy contract. Strictly adhere to these to avoid any claim rejection.
We buy insurance expecting claims to be paid when some unfortunate and unexpected incident takes place. However, when a claim is rejected, it is frustrating, expensive, and disappointing. Let us examine why some claims get rejected.
Health insurance
The policyholder should take the following precautions to avoid the rejection of health insurance claims.
Furnish correct information in proposal form: Any wrong information like age, annual income, lifestyle, medical history, etc., may lead to rejection of the claim and also the termination of the policy. Most insurers do not cover pre-existing diseases and hence asking for a claim in respect of PED will be a waste of time and effort.
Ensure timely renewal of policy: It is important to renew the policy annually before the deadline. Even if an insured is admitted to the hospital only a day later (after the date of expiry), he/she is not entitled to claim.
Intimate insurer within stipulated time: Most health insurance policies clearly mention that the insurer must be intimated within 24 (or in some cases 48) hours of hospitalization if a claim is to be registered. It is always prudent to take the policy from an insurer who is readily accessible 24×7 to the policyholders and so that insured can comply with this condition.
Be aware of the exclusion list: The exclusion list mentions all the cases and situations not covered under the policy. Before making a claim under a health insurance policy, it is advisable to go through the list carefully.