Health Insurance expert advice: What are the reasons why health insurance gets rejected at the last moment? At a time when insurance policyholders need the benefits of health insurance the most, they remain deprived of its benefits. Recently LocalCircle conducted a survey. 39 thousand people were included in this survey conducted in 302 districts of the country. The survey found that overall 43 percent of insurance policyholders faced difficulties in availing their health insurance claims in the last three years.
Of those 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 it took so much time for the patient to receive the claim that the patient stopped any discussion or effort in this regard. In many of these cases, people thought it better to take leave from the hospital as much as possible, because if they had remained in the hospital, they would have had 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, Insurance Solutions She says that sometimes due to jargon and confusing contract terms with insurance companies, disputes arise over coverage and pre-existing conditions. This report of LocalCircles points towards the challenges on the ground. She says that fully understanding an insurance policy involves knowing what is and is not included in it. Maintain a file of all your medical documents and policy documents so that when you make a claim, the processing is quick and hassle-free. (The number of women who have taken health insurance has increased, then why have you not taken insurance till now?)
Policyholders should lodge their claims immediately. 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 purchasing a health insurance policy. Because many times this is the main reason for rejection or delay in your claim.
You should have an updated list of hospitals in the policy’s network…
To avoid any dispute, you should also find the network hospitals in your policy and get treatment there. Many times the insurer has ‘blacklisted’ a hospital. So stay aware of the updated list. Get in touch with the TPA desk of the hospital and let the insurer know if there is any objection. There may be delays or rejections even if there is something wrong with 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 twice before arbitrarily rejecting claims or canceling the policy.
Tags: business news, Free health insurance, Health Insurance, Women’s Finance
FIRST PUBLISHED: May 21, 2024, 13:46 IST