Dispelling myths behind rejection of insurance claims

Health insurance is very commonly used financial term, but have you ever pondered, why there are various reservations surrounding it? As an insurance policy purchaser, you need to thoroughly understand the reasons held responsible for rejection of insurance claim, so that you don’t have to undergo through adversities at adverse time.

The following specifics would help you to understand the reasons behind claim rejection:

Policy lapse a major concern to claim settlement
Policy lapse means your health insurance cover has lost its standing or significance on papers.

Hence, filing an insurance claim for a lapsed policy won’t get you anything, your claim would certainly get rejected. It’s compulsory to pay annual premium towards your insurance plan, on or before the due date.

Providing incorrect information
It’s your primary obligation to disclose all the required information to the insurance company. It’s very important and crucial that you provide accurate and factual information concerning your age, height, weight, occupation, income, existing policy details, and any other details asked for in the application form. If you hide any important facts and don't preserve transparency, then your claim is certain to get rejected.

Not disclosing medical history
Check, that you have provided all compulsory information regarding you and your family’s medical history. Based on this evidence, the insurance company will reach at the premium to be charged, and whether the policy can be issued or not.

The insurance application form asking about your medical history specifics is of significant importance, as your inclusive health graph makes an enormous influence on your claim acceptance/ rejection.

Refraining from medical tests
If you overlook medical tests, your probabilities of facing a claim rejection would increase. When you choose for a higher sum assured it’s compulsory to go through some medical tests.

Based on the information provided in the application form, the underwriter will evaluate the risk and the policy will be allotted.

Specify type of occupation
The nature of profession must be communicated to the insurance company prior to purchasing the health insurance cover.

If the insurance company feels it’s concealed from them, the claim can be rejected. There are professions that carry high risk or are life threatening such as working in a mine, chemical factory, fire-fighting etc. involve high risks.

Casual approach towards health insurance
We often rush through the insurance purchasing process, as the latter comprises a lot of attentive reading and providing never-ending details, while submitting the proposal form.

As individuals, we entirely depend on insurance agents, who do not know several significant details about us and our family’s medical history, honestly this must not be the practice.

All we do is a signature on the application form, and then free ourselves by merely believing the insurance agent, while the second thing we do is issuing a cheque to the agent, without asking much about the insurance policy details.

The agent often fill some inappropriate details or miss some of them as he/ she is always in a rush to sell maximum policies in minimum time.

Hence, make a point to fill the form yourself, authenticate the particulars printed in the insurance policy document with the copy of details filled. In case of any inconsistency, notify the insurance company straightaway to correct it.

Be secured and remain assured! Adopt honest and transparent approach while signing up for health insurance, especially when you are filling the application form.

Remain vigilant while buying health insurance, give out as many particulars required as possible. Not revealing the important details could land you in enormous distress. Don’t let your labour and money go to waste.

(The author is MD and CEO, Cigna TTK Health Insurance)