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Health Insurance Alert: Admitted to hospital, insurance claim rejected? These mistakes will cost you dearly

Ladies, have you got health insurance? Or are you going to get it? If yes, then this news is for you only. So that, in the coming time when you need your health insurance, you do not have to face any problem. Let us understand some important aspects related to health insurance in the light of insurance experts and recent cases….

Health Insurance expert advice: What are the reasons that health insurance gets rejected at the last minute? At a time when insurance policyholders need the benefits of health insurance the most, they are deprived of its benefits. Recently, LocalCircles conducted a survey. 39 thousand people were included in this survey conducted in 302 districts of the country. This survey found that in the last three years, a total of 43 percent of insurance policyholders faced difficulties in availing their health insurance claims.

Of the people surveyed, 67 percent were men while 33 percent were women. Of these, 46 percent were from Tier 1, 32 percent from Tier 2 and 22 percent from Tier 3, 4 and rural districts. Many times it happened that the patient took so much time to get the claim that the patient stopped any debate or effort in this regard. In many of these cases, people thought it better to get discharged from the hospital as soon as possible, because if they stayed in the hospital, they would have to bear all the expenses. ( For more such information related to women and personal finance, you can click here )

Shilpi Arora, co-founder and COO of Insurance Samadhan, says jargon and confusing contract terms from insurance companies often lead to disputes over coverage and pre-existing conditions. This report by LocalCircles points to the challenges on the ground. She says that fully understanding the insurance policy includes what is not covered.

Keep a file of all your medical documents and policy documents so that when you make a claim, the processing is quick and without any interruption.(The number of women who have taken health insurance has increased, then why have you not taken insurance till now?)

Policyholders should file their claims promptly. Inform the insurance company as soon as possible to avoid rejection due to delay. Transparency about pre-existing conditions is important to prevent disputes while buying a health insurance policy. Because many times, this is the main reason for the rejection or delay in your claim.

You should also check the network hospitals in your policy and get treatment done in them to avoid any dispute. The insurer may have ‘blacklisted’ a hospital at times. So be aware of the updated list. Stay in touch with the TPA desk of the hospital and let you know if the insurer has any objections. There should also be delays or rejections if there are discrepancies in your documents.

IRDAI has become strict, insurance companies have become more cautious

IRDAI had directed insurance companies to disclose detailed monthly reports on claims made, which has increased the accountability of insurers. This will make the company think many times before arbitrarily rejecting claims or cancelling the policy.


Bhupendra Pratap
Bhupendra Pratap
Bhupendra Pratap has over 3 years of experience in writing finance content, entertainment news, cricket and more. He has done BA in English. He loves to Play Sports and read books in free time. In case of any complain or feedback, please contact me
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