Health Insurance

7 Reasons Why Your Health Insurance Claim May Get Rejected

Often we are in the habit of not paying much attention to the rules and regulations of insurance policies. Lack of knowledge or seriousness can be counted as some of the reasons why. Your ignorance…

Often we are in the habit of not paying much attention to the rules and regulations of insurance policies. Lack of knowledge or seriousness can be counted as some of the reasons why. Your ignorance towards the health insurance policy you take can cause rejection of the claim. Health insurance claims are denied many times due to various reasons, and thus, you need to understand why your health insurance claim might get rejected. This will help you in taking all the precautionary measures in time and save you from a major financial crisis when a health emergency occurs.

Reasons why your health insurance claim might get rejected:

1. Claiming beyond the amount insured:

There is a sum insured in your health insurance policy that is disclosed to you at the time of buying the policy. Either a family floater or an individual health cover, you’ll get a sum insured which you can claim every year as per your policy. In a case where you have utilized the entire sum insured for that same year, there are chances that the following claims you make will get rejected by your insurer. If a part of your sum assured as per the policy is intact, you might get reimbursement by the insurer later. To be sure about all the terms and conditions of a health insurance policy, you must buy it from a credible insurer. At RenewBuy, you can get a range of insurance policies with transparent terms and conditions at your home’s comfort. Browse and pick the best policy for yourself and your family at affordable prices to avoid any rejection of the claim.

2. Period of policy:

The health insurance policy you buy is valid only for a specific time. You must bear in mind that your health insurance policy, if not renewed in time, will fail to get you a reimbursement. Make sure that your policies are renewed on time. Visit RenewBuy today to renew your policies in a couple of minutes.

3. Not keeping a check on the exclusion:

In the health insurance policy, many diseases are not covered. These diseases are highlighted under the ‘not-covered’ section in the policy. You cannot file a claim for the list of these particular diseases. In a case where you claim an amount against the bills for not covered diseases, you may not get the claim. There are specific plans where some diseases are covered after a certain period. Your claim is bound to get rejected any claim you make for a condition that’s excluded before the fixed waiting period.

4. Pre-existing diseases or symptoms:

In a case where you as a patient have any disease or its symptoms before buying the insurance policy without disclosing it, then your health insurance claim might get rejected. It is mandatory to undergo medical tests to purchase certain health insurance policies so that any disease that may exist becomes evident. You must ensure that you have read all the terms and conditions related to the illness or symptoms before filing for a claim.

5. Misunderstanding the facts:

In many cases, the health insurance claim is rejected due to non-disclosures or false disclosure of necessary details like age, annual income, major ailments or pre-existing conditions. The coverage which is provided to you is based on the information which you give on the proposal form. Avoid any discrepancy and always state the reality when you are buying the insurance policy. There is no solution for a rejected claim because of the wrong information provided by you.

6. Not claiming in time:

You have to claim within a certain period for reimbursement when you have a health insurance policy. In emergency admission, the time you have in hand is 24 hours after the patient is admitted. For other issues, it depends on the policy you have opted. If you fail to apply for a claim within the stipulated time, your health insurance claim will be rejected.

7. Following the wrong process:

There is a fixed process as per the policy which is to be followed to make a claim. Your claim might get rejected if you do not follow the exact mentioned procedure. You may have to inform the insurer about the hospitalization, choosing a recognized hospital as per your policy, filling the policy form correctly etc. Failing to follow the procedure accurately can also land you in a situation of rejection.

Health Insurance claim rejection conclusion:

In a nutshell, you must buy a policy after going through all the rules and regulations correctly. Disclose all the essential information in time to avoid discrepancies, leading to rejection of health insurance claims. When a situation occurs where you have to get yourself or your family member hospitalized, inform the insurer and claim in time to avoid rejections. Always renew your health insurance policy in time and keep a check on the amount you can claim. Health insurance policies can be beneficial in saving you from extreme financial liabilities in case of health emergencies only if you are wise in choosing and remembering all the instructions about your policies correctly.

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