4 Tips to Avoid Health Insurance Claim Rejection

Health insurance claims and rejections are synonym terms and applicants have to undergo extreme inconvenience, mental trauma, and financial instability. With an exponential rise in the number of COVID-19 cases in the country, there are a plethora of policyholders who realize that their health insurance claim is not settled. As a result they end up paying for the treatment from their pockets instead of getting coverage from the health insurer. And, these days health care treatment cost can burn a hole in your pocket.

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    The is not the care with claims related to COVID-19 only, but numerous illnesses where things are transformed and put in certain ways can lead to the rejection of claims.

    Here’s an example to quote such a case:

    Talha Anjum, a 33-year-old music producer was diagnosed with a neurological disorder that caused dizziness. However, things went downhill for Talha and his family when his claim for cashless hospitalization was denied and his wife had to pay a hefty bill of INR 67,000. 

    Talha’s wife Myra says he made regular payments for the health insurance policy but right at the point when his family needed the policy desperately, he was denied cashless hospitalization. Talha and his family felt really disappointed and cheated. The primary reason behind the rejection was that the illness was caused due to pre-existing heart conditions. However, on investigating, Myra found out that his neurological condition has nothing to do with his cardiac ailment and they were actually being cheated. 

    Now the question arises, what if the same happens with you or your loved ones? What is the best way out? How to tackle such a situation and ensure a smooth settlement of health insurance claim? This is what we’ll be shedding light on today. In this blog, we’ve come up with the four tested tips that will help you to avoid health insurance claim rejection.

    You May Like To Read: COVID-19 Insurance Policy in India

    Gather the Right Knowledge

    Undoubtedly, within the past few years, there has been a rise in the number of people who have opted for online health insurance but are unaware of the nuances of the plan. This can turn out to be extremely dangerous and result in similar situations that happened with Mr. Talha Anjum. 

    In order to prevent the rejection of your health insurance claim, it is vital to be aware of the gradations of the Mediclaim policy. The best way to do is to read the fine print of the policy and confirming your doubts with your insurance providers’ representatives. 

    When you purchase online health insurance or an offline health insurance plan the insurance provider offers a free-period of 15 days where the buyer can cancel the plan without paying any sort of penalty. If you figure out any demerits within fifteen days, you can make use of this feature to avoid any hassle later.

    You May Like To Read: Health Insurance for Senior Citizens

    Disclose the Right Set of Information

    Another common mistake that is often leads to the most of the claim rejections of health insurance plans is the disclosure of incorrect information in the application form. The issue arises at the time of claim processing, and the information is reviewed, when it turns out that the information provided by the policyholder is incorrect the health insurer rejects the claim.

    The best way to counter this situation is to provide the right set of information to the provider at the time of application. Providing the right information will make sure that the health insurer is aware of your circumstances and cannot reject your claim on this ground. The disclosure of correct information might lead to an increment in the premium but at the same time will make sure that your claim is processed and provided to your loved ones when they need it the most.

    Avoid Discrepancies in the Application Form

    Discrepancies in the application form are another major reason behind the rejection of health insurance claims. Very often applicants and insurance seekers rely on third parties and agents for filling and submission of the application form, which leads to discrepancies in the form.

    Later at the time of claim, these disparities play a major role in turning out to be detrimental factors that lead to health insurance claim rejection by the provider. The simple tip here is to avoid disparities by filling the form yourself. Moreover, if your form is being filled by a third-party make sure it has the right information and no discrepancy with reference to your documents.

    You May Like To Read: Buy Arogya Sanjeevani Policy

    Choose a Reliable Insurance Provider

    A simple yet effective tip that will definitely help you to avoid claim rejection by health insurer is choosing a reliable provider. When looking for a health insurance provider make sure you indulge in proper market research and comparison. Furthermore, try and choose a health insurer with a high CSR (claim settlement ratio), which is an important figure in determining the claim settlement performance of a provider. You can even look for the best health insurance company on Policybazaar. It offers different health insurance companies with their CSR and other necessary details to choose the best company as per your preferences and needs.

    In a Nutshell!

    With these handy tips, we hope it becomes easier for you to choose the right health insurance provider and avoid claim rejection. Furthermore, whenever choosing best health insurance always compare, shortlist, and then choose the plan for the best results.

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    Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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