Understand Why Your Health Insurance Claim Could Be Denied

A tremendous growth has been observed in the medical field. This has also affected hospital bills due to technical developments observed in medical treatment. The cost of advanced treatments can be difficult to handle and take a toss on your savings. To be able to afford the best treatment available, it is better to purchase a health insurance policy.

Under a medical insurance policy, not only hospitalization expenses, but also other non-hospital charges are covered, including pre- and post-hospitalization. Also, you can choose from the various types of plans available that best suit your requirements. Having an appropriate health insurance policy will make you feel financially secured. Always imagine a scenario wherein you will need a health insurance policy and choose the plan accordingly. The process of raising claims is easy and hassle-free but still there are chances that your claim might get rejected.

Let us look into the reasons why there is a possibility that this will happen.

1. Filing Claim During Waiting Period

Many health insurance plans come with a waiting period. During this particular period, already specified illnesses won’t be covered. Even if you file a claim for one of these diseases at the end of your waiting period, your claim will get rejected. This has to be one of the most common reasons why a health insurance claim request gets denied.

2. Providing Inaccurate Information

When you provide false or inaccurate information or even hide important information such as pre-existing diseases or any other diseases related to health insurance, there are chances of claim rejection. All this information determines your health insurance eligibility as well as the premium amount. Another major reason due to which your claim can get denied is misrepresenting facts.

In case your claim gets rejected for any of the above reasons, don’t get disheartened because there is always a solution to overcome this. Most importantly, you must be thorough about all the terms and conditions mentioned in your policy document. Try and understand the reason why your claim got denied. If you’re still unclear about the reason, you can contact your insurance company to find more details about the same.

Here’s a quick guide for dealing with claim denial.

1. If your claim got rejected because you provided incorrect or incomplete information, then you must provide your insurance provider with the correct details. Always maintain a record concerning the communication you’ve had with your insurer as it can help you in the future.
2. In case your documents weren’t filled completely, you can submit them later within a specific period.
3. If the insurance company finds the treatment unnecessary and rejects your claim, you can provide them with the accurate medical details. You can research about the same or even ask an expert for their opinion. For this, you will have to send a health insurance claim denial appeal letter.

It is essential that you know the reason behind claim rejection or you won’t be able to figure out the solution. This also helps you in filing the appeal. Provide all the necessary documents on time until you achieve what you’re aiming for.

Everyone wishes for a hassle-free claim settlement. Therefore, before purchasing a health insurance policy, make sure you compare various general insurance companies and read reviews about their claim settlement process. To avail the best quotes, calculate the premium using health insurance premium calculator.