Buying health insurance is one of the best ways to safeguard your savings if you or any of your family members need hospitalisation. Today, the process of buying a health insurance policy has become much easier than before, thanks to the online services. However, when it comes to filing a claim, you may face many hurdles.
Then insurance companies have strict rules and regulations for claim settlements and if you don’t abide by them, your claim can get rejected. There are many reasons why the insurance company can reject your claim application. Let us look at some of the common reasons why your insurance claim can be rejected.
Reason 1 – Non-compliance of the claim process
One of the most common reasons cited by insurance companies for claim rejection is non-compliance of the claim process by the policyholder. If you have not provided necessary details in the claim request form or have given incorrect information or fail to submit sufficient documents to support your claim, your insurer will reject the application.
So, when you file a claim, it is better to get in touch with the insurance representative to understand the process and know about the documentation required. This will significantly reduce the chances of rejection.
Reason 2 – Coverage against pre-existing illnesses
One of the important clauses that you must be aware of about health insurance plans is coverage against pre-existing illnesses. Most insurance plans do not cover the diseases that you may have at the time buying the policy. And if you need hospitalisation for such conditions, the insurance company may not cover the treatment cost. Thus, if you raise a claim for such illnesses, chances are high that insurance will not honour it.
Reason 3 – Policy Renewal
Health insurance plans are generally valid for one year. At the end of the one year, the policy expires, and you lose all the benefits, unless you renew the same one or before the maturity date.
Make sure that you set a reminder for your policy renewals and when you renew the same on time, you can avail additional benefits like NCB. But, if you fail to renew the policy, and file a claim, the insurance company will reject it.
So, it is a wise idea to check if your policy is active before filing a claim.
Reason 4 – Waiting Period
All health insurance policies come with a waiting period clause. This means you must wait for a specific period before the coverage becomes effective. The waiting period can range from six months to five years. The waiting period duration depends on the policy terms and conditions.
Your claim will get rejected if you raise a claim for specific conditions on which waiting period is applicable.
Reason 5 – Exclusions in your Policy
Health insurance policy provides coverage against most of the expenses you may incur, however, it does not cover everything; there may be some exclusions. For example, most of the health insurance policies do not cover the treatment expenses for self-inflicted injuries.
And if you file a claim for illnesses or medical procedures that do not fall under the coverage scope, the insurance company will reject your application. So, it is advisable that you read the policy documents carefully to know about the exclusions before filing a claim.
Final Word
Now that you are aware of the top reasons why insurance companies reject the claim request, do your due diligence, and comply with the claim rules.