There are several reasons insurance companies deny claims for. While some reasons might be valid and can’t be avoided, few reasons can be disputed. Make sure you don’t get overwhelmed or emotionally driven by a claim rejection and take the right step by consulting with an expert like ClaimTherapist.
There is an initial waiting period of 30-90 days after the policy is purchased. Any claims made during this period are denied, however, there are some exceptions too. Know more from our experts to get assistance.
There is a specific list of diseases for which the waiting period is around 2 to 4 years such as Hernia, Fissure, Schizophrenia etc. Therefore, if your disease has a waiting period clause, your claim will be denied. Learn more about your policy from our experts and get the maximum benefits of insurance policy.
Every policy has some permanent exclusion in it. So, in case the claim processed is for a disease that is permanently excluded, the claim will automatically be denied. Know your policy better, consult ClaimTherapist experts.
As per the rule, it is compulsory for a patient to be admitted for at least 24 hours in the hospital to apply for a health insurance claim. Any claim processed under this condition will be denied.
In case the sum insured has exhausted, it will lead to claim denial. The ideal solution is to recharge the exhausted sum insured.
During an emergency, you may miss submitting a document. To avoid uncertain claim rejection or insurer's query, consult with an expert before you file a claim.
A silly print error or wrong medical bills by a chemist can lead to a risk of claim denial. Bring your bills and documents to get them verified by ClaimTherapist experts.
There can be several reasons behind claim denial like your treatment is not covered under your policy or sum insured has exhausted. Claims can also be denied because of your pre-existing medical history. Learn more with ClaimTherapist now.
Claim rejection by insurance companies is not the end of the road. Even an insurer/TPA can make a mistake while processing insurance claims. If you feel the claim rejection is not valid, you can dispute and request them to reconsider it with justification and medical facts. Take help from us.
If your claim has been denied, the first thing you need to do is to request your insurer/TPA to reconsider the claim. If you are not satisfied with the outcome, you need to lodge a complaint with the Grievance of the insurance company. If the dispute is not working out, you can further complain to the Ombudsman. Talk to an expert if you need more suggestions.