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Your Insurance Claim is Denied? Know the Possible Reasons Why

Nothing might be more terrifying than discovering that your health insurance company would not pay your mounting medical bills. The chances of your insurance claim getting denied are not uncommon. Every year, millions of claims get rejected, and there are various reasons why an insurance company could do so. It would help if you could figure out why your claim has been denied.

Listed here are some common reasons.

  • Providing incomplete information: Allowing insurance agents to fill out the form on your behalf can be a frequent error made by insurance consumers. Ideally, one should stop perceiving the process of submitting forms as time-consuming.

Important to note is that insurance policies get issued based on the information provided on the proposal form. When applying for health insurance plans for family coverage, individuals may not submit facts about their family’s previous medical problems. Purchasing coverage while concealing the truth may not be a good idea.

  • Falsifying a claim: Health insurance plan aims to provide protection, and it should not be abused for financial advantage. Many claims get rejected because applicants lie while claiming.

The investigation may lead to claim denial if the firm finds something amiss. Learning how to claim health insurance, like the documentation required, time frame, etc., is also essential to avoid denial.

  • Late payment of premiums: Insurers settle only those claims of policies which are active. An insurer may not settle a claim if coverage has lapsed due to unpaid premiums. If you fail to pay a premium on time, you must pay it within the grace period before the policy expires.
  • Failure to present evidence: Providing appropriate proof strengthens your argument by adding credibility. Your claim may only be allowed if you produce evidence of damage.

If you want the insurer to trust your claim, you should take snapshots of the injury and the surroundings. Keep the receipts as evidence of ownership, which may suffice in the future. Providing authentic evidence can facilitate the claim procedure.

  • Claims lost by the insurer: Numerous claims heap with an insurance provider. There may be a chance that the insurance company has misplaced your claim and that it has not been entered into their database. This can result in the denial of the claim.

In such circumstances, the policyholder’s sole recourse would be to act quickly before the deadline for submitting the claim. The best practice might be to preserve copies of the proofs submitted.

Therefore, if you need to file a claim, you must act swiftly without being pursued by the insurance company. Make a claim immediately while the specifics may still be fresh in your mind.

* Standard T&C Apply

Ways to guarantee an insurance claim gets approved:

  • Refrain from concealing crucial facts.
  • Fill up the form manually.
  • Do not allow the policy to expire.
  • Record evidence and keep proof of claim submitted.
  • Do not provide false insurance information.

* Standard T&C Apply

Delaying the filing of a claim can lengthen the procedure. The health insurance provider also might disapprove of a claim that has been pending for a long time.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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