Health Insurance: If you make these mistakes, then your health insurance claim will be rejected..

What is the biggest reason for taking a health insurance plan? To reimburse the expenses incurred during cashless hospitalization or hospitalization. But despite paying the premium, some people's health insurance claim gets rejected. Despite paying the premium, if this happens, you will feel 100% cheated. It is natural to feel like this. But it is very important to know and understand the reasons behind it.

In some cases, health insurance companies refuse to pay the claim at the last moment. As a policyholder, you would never want this to happen to you. The situation of hospitalization of yourself or a family member is already stressful, and in such a situation, when the medical claim is rejected, it increases the stress further. In this article, we will understand why health insurance claims are rejected and how to avoid them.

Why are health insurance claims rejected?

1. Wrong information:

Entering wrong information in the medical insurance form can lead to the claim being rejected. Do not write wrong information about age, income, profession, and even hobbies.

2. Hiding diseases:

Not giving information about pre-existing diseases or certain habits, such as drinking alcohol or smoking cigarettes, can also lead to the rejection of the health insurance claim.

3. Waiting period:

Every health insurance plan has a waiting period. If any claim is made during this waiting period, it will be rejected. Usually, the waiting period is 30 days. But in the case of maternity, the waiting period can be 24 to 36 months. For pre-existing diseases, the waiting period can be 2 to 4 years.

4. Cashless Claim:

If you are getting treatment in a hospital that is not in the network of the insurance company, then the company can reject the claim. However, you can get it reimbursed from the company later.

5. Wrong Claim:

Some services are not included in every health insurance plan. Such as dental, AYUSH, OPD, maternity, etc. In such a situation, the company may reject such a claim.

6. Lapse policy:

Every health policy has validity. Like 1 year or 2 or 5 years. Once this validity ends, the policy has to be renewed. If you do not renew the policy on time and, in the meantime, you make a claim, then the insurance company will reject it.

7. Claim more than the sum assured:

Every health insurance policy has a fixed sum assured. If the claim amount is more than that, then the company can reject it.

8. Not giving information on time:

If you do not inform the insurance company about your hospitalization on time, then the insurance company can reject your cashless treatment claim.

How to avoid

- Always fill the insurance form yourself. Do not leave the form to the agent. You know yourself more than the agent and hence there are less chances of mistakes.

- Do not hide any pre-existing disease. Do give information about it.

- Do not claim during the waiting period.

- If the policy has lapsed, get it renewed in time.

- Do inform the company within 24 to 48 hours of being admitted to the hospital.

Disclaimer: This content has been sourced and edited from News 18 hindi. While we have made modifications for clarity and presentation, the original content belongs to its respective authors and website. We do not claim ownership of the content.