health insurance

Steps to follow for prevention of health insurance claims getting rejected

Buying a health insurance policy may allow the insured individual to claim compensation for medical expenses. Whether you are faced with a medical contingency or need treatment for health issues arising due to the uncertain pandemic having a reliable Mediclaim policy can save you from spending your savings on health care. However, your application itself does not guarantee an approved medical policy claim. Yes, your chosen health care provider might unexpectedly reject the claim you’ve raised. However, a few measures can prevent this.

Things to do to prevent rejection of your health insurance claims 

Know the waiting period 

Most insurance policies come with a waiting period. This period is referred to as the time from the activation of your policy during which you cannot file a claim. Typically, this period is for 15 days but may vary according to the chosen policy. In case of a pre-existing ailment or a senior citizen health insurance policy, the waiting period may range between one to four years. During this period, you may not be able to file a claim to cover the cost of the treatment of your pre-existing health condition. So, if you happen to apply for a claim during the waiting period, there are high chances your claim will be rejected.

Not disclosing your pre-existing ailments to the insurance company

Hiding a pre-existing disease or not mentioning it to the insurance provider when buying the policy can land you with a rejected claim to cover treatment of such a disease. 

Know what is not covered under the Mediclaim policy

Every medical insurance policy has a fine print of terms and conditions that enumerates the exclusions. Before you avail of a health insurance plan, make sure to check the exclusions mentioned under it. For instance, most insurance companies don’t cover the cost of dental treatments you incur. It is best to check the list of exclusions and other conditions to avoid disappointment and rejection of the claim.

Make sure you submit proper documents 

Make sure you submit all the necessary documents to your insurance company, including medical bills and receipts, while applying for a claim. Failure to provide all the required documents or submit incorrect documents can lead to an outright rejection of your claim request. 

Not filing a claim on time 

Delaying the filing of your claim can cause a rejection. Every health insurance policymaker maintains that the claim needs to be filed within a certain period from the date of commencement of the treatment. It should not exceed seven days since the treatment began in most cases. Hence, any delay in filing the claim request beyond the specified period will result in the insurer’s rejecting the request. 

Miscellaneous aspects 

Make multiple copies of your documents submitted to the insurance provider along with the claim form. Also, every medical bill, doctor’s prescription and other proof should be collected and presented as proof. While signing the policy, ensure to run through the entire terms and conditions pronounced in the policy and consult the agency representative for any doubts regarding the fine print. 

Ensure that you submit the claim request to the company within the stipulated time. Analyse the form well before submitting it, as insufficient documentation can lead to rejection. If you identify any mistakes, make the necessary corrections before filing a claim. 

If you are looking for a dependable mediclaim policy, you can bank on the Mediclaim policies offered by Bajaj Finserv. The company partners with top-rated insurance companies to bring you the best health insurance policies that have your best interest in mind. 

From individual health insurance to the family floater, employee medical policy, critical illness or senior citizen health insurance policy, top-up medical insurance plans to personal accident insurance, you can avail of a range of policies. Simply ensure you follow the policy guidelines while filing for a claim to prevent any rejection. 


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