PuneinvestPuneinvest
  • Home
  • Mutual Fund
  • Form Download
  • BNPL
  • Mediclaim
  • Post Office
Reading: 9 Reasons Why Health Insurance claim rejected?
Share
Aa
PuneinvestPuneinvest
Aa
  • Mutual Fund
  • Financial Planning
  • SIP Cancellation
  • Post Office Saving
Search
  • Mutual Fund
  • Financial Planning
  • SIP Cancellation
  • Post Office Saving
© PuneInvest 2023. All Rights Reserved.
Puneinvest > Blog > health Insurance > 9 Reasons Why Health Insurance claim rejected?
health Insurance

9 Reasons Why Health Insurance claim rejected?

Last updated: 2022/07/11 at 5:43 PM
Rajendra Todkar Published May 12, 2022
Share
Health insurance claim rejected
Health insurance claim rejected

Health insurance is among the best methods to ensure medical bills from illness, surgeries or accidents are protected.

Contents
1. Incomplete Claim Information2. Missing Details3. The non-disclosure of medical information4. Lapsed Policy5. Delay in filing the insurance claim6. Pre existing diseases7. Waiting period8. Hospital Stay9. Policy Period

What happens if your medical claims are rejected? What can you do to avoid this scenario?

Here are some reasons that your health insurance claims could be rejected.

- Advertisement -

1. Incomplete Claim Information

If there’s an unintentional mistake made while filling in the form such as the information about income, age, occupation details or any other details requested during the application, it could result in not only an rejection of the claim but also the end of the policy.

Paperwork errors – For example, submitted claim for husband, but policy number enter wife’s policy no. Family Floater Plan create every person separate policy number.

2. Missing Details

There was insufficient information provided with the claim or pre-authorization request.

- Advertisement -

For example, you have requested an MRI of your leg, but your health provider didn’t send any information about what was wrong with your leg.

3. The non-disclosure of medical information

When an insured person hides their medical history, there is a higher chance that their health insurance claim will be denied.

The health insurance companies do not provide coverage for pre-existing illnesses like diabetes, high blood pressure and others. 

- Advertisement -

4. Lapsed Policy

Many people put off renewing their health insurance policies. If the policy expired due to non-payment of the premium and claimant’s claims were not paid during that period that will result in the rejection of claims. 

To be able to claim successfully your health insurance policy needs to be valid and not expired.

5. Delay in filing the insurance claim

Health insurance claims may be denied in situations in which the policyholder, or relatives of the policyholder file the claim after the time period. 

- Advertisement -

Most claims must be processed within 7 to 15 days following discharge from the hospital.

6. Pre existing diseases

Along with the exclusion of diseases that pre-exist for a certain time in addition, there are other exclusions are also included with some plans. 

- Advertisement -

Insurance policyholders are usually not studying other exclusions in the terms and conditions that define the various exclusions. 

Some health insurance plans do not cover any diseases you already might have while buying the policy

Certain exclusions include injuries or accidents resulting from to being under an influence from alcohol. 

- Advertisement -

7. Waiting period

There is a mandatory waiting time of at least 30 days following the purchase. In the event that a policyholder submits a claim within this time this could lead to claims being denied.

8. Hospital Stay

If you are not hospitalized for a minimum 24 hours and are discharged early by the hospital, policy claim might be rejected.

- Advertisement -

9. Policy Period

The health insurance policy is typically valid for one year. When one year, the policy becomes expires. This means that you must renew the policy.

For instance, you could have to pay a lower cost. However, if you don’t renewal your health insurance plan the policy will expire.

If you do not know the policy has expired and you make claims, they will be rejected.  Therefore, you should be sure to verify the expiry date on the health insurance plan.

Table of Contents
  • 1. Incomplete Claim Information
  • 2. Missing Details
  • 3. The non-disclosure of medical information
  • 4. Lapsed Policy
  • 5. Delay in filing the insurance claim
  • 6. Pre existing diseases
  • 7. Waiting period
  • 8. Hospital Stay
  • 9. Policy Period

Share This Article
Facebook Twitter Email Copy Link Print
By Rajendra Todkar
Follow:
Rajendra Todkar is an experienced finance, investment, and insurance writer with a passion for educating readers about personal finance and helping them make informed decisions. With over 15 years of dedicated experience in the field, Rajendra Todkar has established a strong reputation for providing valuable insights and practical advice.
Previous Article child future Is it Good to Invest Children Gift Fund (CGF)?
Next Article No claim bonus in health insurance Benefit of No-Claim Bonus in Health Insurance

Latest Post

  • The Regulatory Landscape of Pay Later: Consumer Protection and Regulations
  • How to select Right Mutual Fund?
  • Generating Reliable Income via Debt SWP Strategy
  • The Importance of Aligning Your Investments with Your Goals
  • ePayLater Review
  • The Benefits of Investing in Mutual Fund for Long-Term Wealth Growth
  • Volt Money Loan Against Mutual Fund Review

You Might Also Like

E insurance account
health Insurance

e-Insurance Account (eIA): Your Key to Hassle-Free Policy Management

July 26, 2023
hospital cash
health Insurance

Hospital Daily Cash Insurance: A Complete Guide

February 15, 2023
Not cover in health insurance
health Insurance

16 Things not cover in Health Insurance

May 24, 2022
Health Insurance term 768 432 PixTeller
health Insurance

Commonly Used Health Insurance Terms and its Meaning

May 19, 2022
How to choose health insurance plan
health Insurance

How to choose Health Insurance Plan in India

May 18, 2022
Claim settlement ratio
health Insurance

Claim Settlement Ratio – Important in Health Insurance?

May 18, 2022
waiting period health insurance
health Insurance

How Does Waiting Period work in Health Insurance?

May 18, 2022
Pre post hospitalization
health Insurance

Pre & Post Hospitalization in Health Insurance

May 17, 2022
Show More
© 2023 Puneinvest. All Rights Reserved.
  • SiteMap
  • Terms and Conditions
  • Disclaimer
  • Privacy Policy
  • About Us
  • Advertise with Us
  • Our Services
  • Contact Us
Welcome Back!

Sign in to your account

Lost your password?