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Reasons Why Your Health Insurance Claim May Get Rejected

By Finserv MARKETS - Feb 26,2019
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Reasons why Your Health Insurance Claim may get Rejected

A good, comprehensive health insurance policy will protect you from the financial implications that come with any illness or accident that may befall you. Many a times, hospital and other medical bills can spiral out of control and run the risk of imposing a huge financial burden at an already trying and difficult time. Having your health plan in place makes this scenario significantly easier to deal with.

Even though it is relatively hassle-free to claim your health insurance nowadays, there still may be instances where certain claims could get rejected. This may be because of reasons you may have overlooked or misunderstood.

Common Reasons Why Health Claims Are Rejected:

  • Pre-existing Illnesses

A pre-existing illness is a health condition or illness that already exists at the time of signing the insurance contract. Usually, health insurance plans do not cover any pre-existing illnesses for the first 2 to 4 years.

  • Non-Awareness of the Terms & Conditions of the Policy

As a rule of thumb, it is extremely important to read the documentation of the policy before signing the same. If you miss reading the fine print, you may end up filing a claim for an illness or health issue that is not covered under your policy.

  • Incorrect Information

A major reason for rejection of a health insurance claim is incorrect information entered in the policy contract. This may happen sometimes because an application form may be incorrectly filled by an insurance agent, who may not be the best authority on your personal medical history. It is always in your best interest to fill all forms yourself and double check the same to make sure that the information provided on all forms and collaterals is 100% correct.

  • Hospital Room Sub-let Limit

The cap on the reimbursement of your health claim is set as per the room-rent limit of the hospital that you are admitted to. It is generally a good practice to select a hospital room where the rent equals 1% of the total sum insured.

  • Non-Renewal of Policy

It is important to keep tabs on your health insurance policy and renew it at the correct time, before the due date. Claims that are filed in the waiting period (the time period between the start and end of the policy application) are not taken into consideration. Always make sure your policy is active and that you have understood all the provisions, terms, and conditions of the same.

Having a good health plan is of utmost importance in today’s world, where medical bills are continuously rising, and lifestyle diseases are at an all-time high.

Buying a health plan with Finserv MARKETS is easy, convenient and completely hassle-free. What’s more? The entire process is smooth and a host of other features and health insurance benefits are offered too. So why wait? Head over to our website and secure yourself, today!

Read our top blogs to know more about health insurance in India:

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Bajaj Finserv Direct Limited ("BFDL") is primarily engaged in distribution of financial products and services through its digital platform (“Bajaj Finserv MARKETS”) and inter alia renders services of customer acquisition, providing preliminary credit support activities, fulfilment services and post-acquisition customer services to Banks, NBFCs, HFCs. BFDL is also a registered Corporate Agent (Composite) under valid IRDAI registration number: CA0551 valid till 10-Apr-2024 for solicitation and servicing of Insurance Products. Registered Office: Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035 CIN: U65923PN2014PLC150522