Steps to AvoidYour Mediclaim Being Rejected6

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steps to avoid your mediclaim being rejected6

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Health insurance is supposed to guard us against sudden healthcare expenses. However, after submitting their claim,

often, customers find that either their

claims have been denied or cut. A lot of

people meet with this fate, which is why

health insurance companies have a large

number of consumer cases pending

against them. Insurance companies

argue that it isnt always their fault. It

is rather the failure of the policyholder

to understand the policy that he has

bought. He has either not read the

terms or not followed the procedures,

clearly mentioned in the policy. That is

why he doesnt get his claims passed.

Can something be done about this?

How can you ensure that your claims

are met? Here are the cardinal rules

to remember to avoid your health

insurance claim being rejected. Some

of these rules apply before you make a

claim; others after you make a claim.

Here are the cardinal rules to remember to avoid your health insurance claim being rejected. Some of these rules apply before you make a claim; others af ter you make a claim.

steps to avoid your mediclaim being rejected6

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1. Be 100% truthful

Disclose all information asked, truthfully. Remember, insurance is a contract between the insurance company and a policyholder. So, if you want the insurer to keep its end of the bargain, you must keep yours. Provide the insurance company with complete and accurate information (name, age, gender,

complete address, contact number, past medical history, etc) at the time of filling up

the proposal form.

steps to avoid your mediclaim being rejected6

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2. Read the document carefully

Disclose all information, truthfully. Remember, insurance is a contract between the insurance company and a policyholder. So, if you want the insurer to keep its end of the bargain, you must keep yours. Provide the insurance company with complete and accurate information (name, age, gender, complete address,

contact number, past medical history, etc) at the time of filling up the proposal form.

steps to avoid your mediclaim being rejected6

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3. Understand the clauses

Be careful about the technical or legal language presented to you. Often, insurance companies will provide you with a document and explain the contract to you. However, read the document presented to you and seek to understand the legal clauses stated in the document in plain English. If needed use

our Insurance Helpline.

steps to avoid your mediclaim being rejected6

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4. Pay your premiums on time

Renew your policy before the due date. But while doing that, also read the policy wording so that you do not miss out on new inclusions and exclusions. Ensure you pay premiums on due dates before expiry of the grace period, as diagnosis of illness beyond the grace period is not covered. A revival of policy subsequent to

its lapse will be considered as new policy and hence there will be waiting period

operative from the date of revival.

steps to avoid your mediclaim being rejected6

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5. Complete all the required paperwork

The insurance company will not pay your claim if it isnt in line with its agreed terms and conditions. Remember, its a contract. Keep the doctors prescription or admission notes recommending the procedure or surgery and other investigation reports in well-ordered file.

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6. Understand the claims process

Insurance companies now insist on a short deadline for claims. If you do not submit your claim within that period, your claim will be rejected. For cashless hospitalisation you have to provide complete documentation and details from the onset of the ailment along with diagnosis and planned treatment. Also, send

advance intimation to the Third Party Administrators and insurance companies at

least 48 hours before in case of planned hospitalisation, and at the earliest in case of

emergency hospitalisation. With these precautions taken, chances that your claims

get rejected reduce to a large extent

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