How Can You Avoid Health Claim Rejections At An Old Age?

Minimising the risk of health insurance claim rejection becomes less scary when you prioritise record-keeping and proactive healthcare to help steer clear of potential claim denials by insurance providers

Amit Sethi
November 18, 2023
Health insurance claim form

Health insurance claim form

Securing a health insurance plan for old age is crucial in managing medical expenses. However, if you fall ill, get hospitalised, undergo treatment and encounter a claim rejection, the financial burden can be overwhelming. Paying out of pocket can raise concerns about sustaining a comfortable retirement lifestyle. So, proactively addressing these challenges is essential to ensure the intended financial protection in your golden years. Let’s find out some important points that can help you avoid a claim rejection by the insurance companies.


Avoid Giving Wrong Information To The Insurance Provider

Even if you unintentionally provide inaccurate information, it can work against you when it comes to insurance. It’s crucial to ensure accuracy in details such as your address, documents, habits, hobbies, and other important information. Concealing information may elevate the risk of your insurance claim being rejected. While the temptation to withhold details like smoking habits, job nature, or interest in adventure sports might seem like a way to save a few hundred on premiums, the potential cost of claim rejection outweighs any short-term savings.

Avoid Hiding Pre-Existing Medical Conditions

Concealing pre-existing conditions can have adverse consequences if exposed. When completing your insurance application, it’s crucial to openly disclose any pre-existing medical conditions. While this may lead to an increase in premiums, it ensures that you won’t face rejection when filing a future claim. Additionally, if there is a specific disease prevalent in your family history, it’s essential to disclose that information as well.

Do Not Claim For Services Not Covered Under The Plan

Often, individuals overlook the importance of thoroughly reading their insurance documents. This oversight can have significant consequences during the claims process when they discover that certain expenses are not covered by the plan. It is crucial to have a clear understanding of the coverage details, including what is included and excluded. When in doubt, it’s advisable not to make assumptions. Instead, seek clarification directly from the insurance company or your agent. For instance, if dental treatments are excluded, any claims related to dental procedures will be rejected.

Do Not Let The Policy Lapse

If the policy has lapsed, the insurance company is not entitled to pay you any claim. Despite many reminders, policy lapsing is very common. Hence, you should ensure that the policies are renewed on time.

Do Not Claim More Than What Is Permitted

Every insurance policy has a claim amount limit, which is subject to the sum assured, as mentioned in the policy document. You cannot claim any amount beyond that limit. So, any claim over and above the sum assured will be rejected.

Health insurance is a very important part of your personal finance portfolio. It saves you from unanticipated medical expenses. Hence, you must read the policy document carefully, give the correct information to your health insurance provider, and follow the right process to ensure that your claim is not rejected.


The author is an independent financial journalist

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