In today’s world, medical expenses are rising so rapidly that a major illness can cripple a family’s finances. In such a situation, health insurance has become not just an option, but an essential safety net. However, many people buy policies but face problems at the time of a claim due to a lack of necessary information or minor mistakes.
Insurance sector data shows that often, claim rejections are not due to the illness itself, but rather problems related to policy terms, incorrect information, or documentation issues. In many cases, claims are rejected due to concealing pre-existing conditions, not completing the waiting period, or discrepancies in documents.
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Hiding medical history can be costly
The most important thing when buying health insurance is to provide accurate and complete information. Many people think that disclosing a pre-existing condition will increase the premium, so they hide the information.
However, insurance companies verify medical records at the time of claim. If a pre-existing condition is discovered during the investigation, the claim may be rejected, or the policy may even be canceled. Reports indicate that approximately 25% of claim rejections are due to concealing information about pre-existing conditions.
Buying a policy without understanding the terms is a big mistake
Often, people buy policies hastily after seeing advertisements or listening to agents. Later, at the time of claim, they discover that many illnesses or treatments are not covered by the policy.
Many claims are rejected because the treatment is not covered under the policy or the waiting period has not been completed. According to reports, in many cases, people claim for treatments that are not included in the policy or are not yet eligible for coverage.
Choosing a policy based solely on low premiums is the wrong decision
Policies with low premiums often offer limited coverage. Later, when hospital expenses are high, the full amount may not be reimbursed.
If the sum insured is exhausted quickly or there are conditions like room rent limits, the claim amount received may be less than expected. Therefore, it is crucial to choose coverage while keeping your needs, the number of family members, and potential medical expenses in mind.
Claim delays or rejections due to incorrect documents
Documents play the most important role in the claim process. Hospital bills, discharge summaries, test reports, and doctors’ prescriptions must be accurate and complete.
Insurance companies may withhold claims if the documents are incomplete or incorrect. In many cases, claims are rejected due to errors in the documents or delays in submitting them.
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The right plan and accurate information will ensure you receive full benefits
Health insurance is only beneficial when it is purchased with understanding and used correctly. If you understand the policy terms, provide accurate information, and keep your documents safe, the likelihood of your claim being approved increases significantly.
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Rohit P
My name is Rohit Pal, and I have been working in the field of journalism for the past five years. During this time, I have written on a variety of topics, including business, automobiles, technology, and politics. I have worked with several major organizations and am currently working with Timesbull.
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