3 min read
Updated on Dec 27, 2022
There are times when your health insurance claims get rejected or are delayed. Most often than not, it is your fault which leads to any delay or rejection of your claim. You make mistakes with your claim process which creates a problem with your health insurance claim.
Not following the intimation time-line
Health insurance companies have a particular timeline within which your health insurance claim should be notified to them. After notification of the claim, it is approved and the settlement is done. If you don’t follow the time-line your claim falls in jeopardy. To avoid this pitfall, intimate the insurance company in time. If it is a planned hospitalisation, inform the company 3-4 days in advance of such hospitalisation and avail approval. If it is an emergency case, intimation should be done within 24 hours of hospitalisation for easy settlement.
Health insurance claims require a complete set of your medical documents and hospital bills. Failure to submit the required documents leads to claim rejection or delay. So, when you make a claim in your policy, make sure to obtain and submit all original medical bills and reports as required by the insurance company to process your claim.
Your claim form should specifically state the policy number, date of hospitalization, and other treatments, the reason for the claim, your name, and other personal details, etc. All the required information should be correctly filled and submitted. Wrongly filling in a claim form or incomplete form would result in the delay of your claim settlement.
Every health insurance plan has exclusions. Expenses related to such exclusions are not paid by the company. So, if you make a claim for an excluded expense, your claim would be rejected. To avoid this mistake, read your policy document carefully. Understand the exclusions so that you know for what you are exactly covered under your health insurance plan.
If you make a false claim, you are committing a fraud. The result would obviously be the rejection of your claim. In fact, the insurance company might also take punitive action against you for making a false claim.
Health insurance claim process is simple. It just requires you to follow some basic steps. If you follow the steps and avoid the above-mentioned pitfalls, your claim would be settled easily and also quickly.
Also read: IRDA Health Insurance Claim Settlement Ratio 2022 for Top Health Insurance Companies
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