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5 possible health insurance claim rejection scenario.


When we invest in health insurance, we usually sit back and relax thinking we are all set. It is true a health insurance secures you and your family in an event of sudden illness or an accident. With the rising costs of materials, medicines, hospitalization our costs of living is on a all time high. It is highly recommended to invest in a health insurance policy.

All health insurance policies guarantee easy claim settlements, however you can never be too sure. Some claims do get rejected for reasons not actually known to us. This would put us in a very hot soup.

The reasons for rejection of a health insurance claim could be varied. Some of the reasons are:

  1. Not knowing of a pre-existing illness:

During the initial phase, health insurance policies do not cover illness existing from before. 3 to 4 years could be the range of the initial phase.

So a pre-existing illness is a health condition that exists even before signing of the insurance agreement. It is highly recommended to go through the terms and conditions very minutely before you put your pen to the paper. It is best to let the insurance company know about your present illness and health conditions.

Bharti AXA always advises on declaration of pre-existing health conditions.

  1. The policy’s terms and conditions:

There are terms used in the policy’s agreement that are very legal and sometimes very complex to comprehend. Taking an expert’s opinion would not be a bad idea at all. Make sure you understand clearly the coverage limits, what all are excluded and other terms and conditions.

  1. Lack of correct information:

The insurance holder must provide all the correct information. Even though it so happens that the insurance agent fills in the forms, please be advised to go through the same so that you know that all the information filled in are true and best to your knowledge.

If you have ailments or pre-existing illness, make sure all the relevant documents are provided to the insurance company.

  1. Room rent sub-limit:

When we are hospitalized, we would be charged for the room or the bed we would be occupying in the hospital. The health insurance pays for that too, however you need to make sure that it exists in your agreement and that the limit of the rent amount is equal to one percent of the total sum insured.

  1. The insured forgets to renew health insurance:

As in the case with all insurances, the renewal of the policy in health insurance must be done well within the policy period, failing which, nothing can be claimed. Bharti AXA reminds their clients to renew their policies well with the period.

Many of us have reminders on our smart phones and tablets or we can always use the old school methods of marking on our wall or table calendars’ which we often refer to.

So whatever maybe the reason for rejection on your health insurance claim, make sure you do not oversee the above mentioned points to be on the safe side.

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