So, you went through a distressing medical ordeal. And, now the last thing you would want is to have your health insuranceclaim get rejected. But there is always a possibility of having your claim get rejected for a number of reasons. You might have submitted the wrong details or missed the last date of filing the claim.
In order to make sure that your claim doesn’t get rejected, make sure not to make any of these mistakes.
1. Providing Wrong Information In The Policy Document
If you provide incomplete or incorrect details in the health insurance application form, the insurer might just reject the claim. Thus, make sure to not hide any existing medical condition from the insurer. In case you do that, you will not be covered for the illness upon filing a claim.
Moreover, you need to include all the details correctly while filling the claim form. So, check if things like the doctor’s name, patient’s name, and other information have been accurately provided.
2. Not Submitting The Right Documents
At times, it can just be the matter of filing wrong documents while making the policy claim for family health insurance plans. Therefore, you should double-check all the documents before you submit them. It includes your prescriptions, discharge summary, hospital bills, and medical reports. All documents need to contain the right information to ensure an easy claim settlement procedure.
3. Not Understanding About Policy Exclusions
Every medical insurance plan comes with a number of exclusions and inclusions. For example, the insurer might not cover the claims based on self-inflicted injuries, wars, alternative therapies, cosmetic procedures, and adventure activities injuries.
In case a claim is filed for any exclusions, your insurer will straightaway reject that. So, you need to read all the policy documents carefully, especially the ones about exclusions and inclusions.
4. Not securing prior authorization
You might need prior authorization for availing of certain benefits of medical insurance, like non-emergency benefits and cashless hospitalization. Your claim might just get denied if you fail to secure prior authorization from the insurer.
5. Filing Claims While Under Waiting Period
Claims related to pre-existing conditions cannot be filed prior to the waiting period getting over. There are medical conditions that have a long waiting period of three to four years. Filing a claim for a medical condition that’s under a waiting period will make the insurance claim get denied.
The Bottom Line
It’s important to talk to the insurer and reach a solution if your medical insurance claim gets rejected. Ask your insurer about the reasons for your claim to get rejected and what you can do to remedy the situation. Your insurer will surely help you find a way out.