Useful tips for insurance claim settlements

Useful tips for insurance claim settlements : Having an insurance claim rejected is every policyholder’s nightmare. To have to pay out of your pocket when your insurance policy should be doing the needful is certain to shake your confidence in the insurer. But think about it: The insurer’s responsibility is to settle claims, so why would it reject your claim at all?

Below are some reasons why:

1. Providing incorrect information
2. Non-disclosure of health and lifestyle details
3. Non-payment of premium
4. Deliberate fraud
5. Claiming against ‘exclusions’
6. Claiming for superfluous expenses

So, how do you ensure that your insurance claim process is seamless and hassle-free? Make sure to not give your insurer reason to reject your claim. Let us consider the reasons for rejection mentioned above and discuss how you can avoid them.

1. Providing incorrect information – This is a common problem among people who leave the filling of the application form to the agent. Even if you do allow your agent to fill in the details, make sure to verify all information, including your personal details, nominee details (in case of life insurance), medical history details (in case of life and health insurance), driving record (in case of motor insurance), etc.
2. Non-disclosure of health and lifestyle details – You might not consider some details of your lifestyle and health to be important, but your insurer would nevertheless require them for underwriting your policy. For instance, even someone who drinks once every few months should not call himself a teetotaller; should the insurer find out, it could not only reject his claim but also his policy.
3. Non-payment of premium – Under no circumstances should you allow the policy to lapse. Limit the potential for wrongdoing if a third-person (e.g. an agent) deposits the premium on your behalf by issuing a cheque rather than giving cash. If you must pay in cash, visit the insurance office in person instead. In the case of a lapsed policy, the insurer would be under no obligation to honour your claim.
4. Deliberate fraud – Some policy-seekers might be drawn by the possibility of low premium to knowingly conceal, for example, a health condition in the case of a health insurance policy. In such a case of intentional fraud, the insurer would be well within its rights to reject both the claim and the policy together.
5. Claiming against ‘exclusions’ – Frequently enough, claim rejections occur simply because the customer has not read the policy document properly. Most health insurance plans, for instance, come with exclusions or waiting periods. For example, certain listed health conditions might have a waiting period of two years. This means that one cannot claim for medical expenses arising from these conditions until the two-year waiting period is over. To claim for such exclusions within this period would result in claim rejection.
6. Claiming for superfluous expenses – In health and motor insurance especially, the insurer might reject a claim because it is non-essential. This could take the form of additional but unnecessary procedures in a hospital or inflated car repair bills at a non-network garage.

Even if your claim is accepted, settlement sometimes takes a long time. Hence, it helps to submit the required documents and to intimate the insurer within the specified time frame to avoid delays.

 

Useful tips for insurance claim settlements : Useful tips for insurance claim settlements : Useful tips for insurance claim settlements