Top reasons why your Health claim got rejected

Top reasons why your Health claim got rejected

When purchasing health insurance, most people have a habit of neglecting the fine print. It is mostly caused by a lack of attention, and this inattention to health insurance might result in a claim being denied. When purchasing a health insurance coverage, make certain that all terms and conditions are completely understood. All insurance plans have terms and conditions for claim processing, and health insurance is no exception.

Purchasing health insurance coverage is an excellent way to protect your hard-earned money in  case you require medical treatment. In light of the multiple options accessible to customers nowadays, this process has become simple. A coverage may be purchased quickly, even online, but are claims always settled? There might be a variety of reasons why a claim is rejected.

Inadequate understanding of claim handling

Since a health insurance policy is a contract between two parties – user and the insurance company – one must strictly follow the claim process. Many times, insurance buyers fill out application forms incorrectly or incompletely. There might be a lack of documentation, for example. It is best to clear up any confusion by asking the agent or insurance company representative any questions you may have about the coverage you want to purchase. This reduces the likelihood of claim rejection.

Hiding pre-existing disease

Some health insurance policies do not cover any diseases you may already have when you purchase the coverage. If you become ill as a result of these conditions and require hospitalization, your health insurance provider will not cover the cost of treatment. Hence, there is a good risk that your health insurance claim may be denied.

Not renewing policy

Health insurance coverage is typically good for one year. The policy will end at the end of one year. Therefore, you must renew your coverage. Renewal of an insurance comes with additional benefits. For example, you may be asked to pay a lower premium. However, if you fail to renew your health insurance coverage, it will expire and if you file a claim being unaware that your insurance has expired, it will be denied. Hence, you should double-check the expiration date of your health insurance coverage.

Making claim before waiting period expires

A waiting period for a health insurance plan implies that you must wait for a specific amount of time before you can avail the insurance. Some insurers, for example, cover pre-existing conditions or maternity benefits after a couple of years of waiting period. This period is determined by the insurance company’s terms and conditions.


Health insurance provides financial protection against disease. However, there are several circumstances in which you cannot file a claim. These are referred to as exclusions. If you file a claim against a policy exclusion, it will be denied. To prevent this issue, always properly study the policy document.

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