There are several reasons insurance companies deny claims for. While some reasons might be valid and can’t be avoided, few reasons can be disputed. Make sure you don’t get overwhelmed or emotionally driven by a claim rejection and take the right step by consulting with an expert like ClaimTherapist.
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There can be various reasons behind claim denial (e.g. the treatment is not covered under your policy, your sum insured got exhausted etc.). Claim can also get rejected because of your pre-existing medical history. Learn more with ClaimTheapist now.
Claim rejection by insurance is not the end of the road. Even insurer/TPA can make a mistake while processing the claim. If you feel claim rejection is not valid, you can dispute and request them to reconsider the claim with your justification and medical facts. Ask us to learn more.
If a claim is denied, the first thing you need to do is to request your insurer/TPA to reconsider the claim. If you are not satisfied with the outcome, you need to lodge a complaint with Grievance of the insurance company. If the dispute is not working out, you can further complaint to Ombudsman. Talk to an expert if you need more suggestions.
A reimbursement claim gets rejected due to several reasons.
The most possible reasons for claim denial by insurer are as follows:
Do not hurry in submitting medical claim. Get an expert to prepare and file your claim instead.
During an emergency, you may miss submitting a document. To avoid uncertain claim rejection or insurer's query, consult with an expert before you file a claim.
A silly print error or wrong medical bills by chemist can lead to a risk of claim denial. Bring your bills and documents to get them verified by ClaimTherapist experts.