Filing an insurance claim only to see it rejected can be frustrating and financially stressful. Whether it’s a health, motor, or life insurance policy, the denial often comes down to overlooked details or avoidable mistakes. In India, claim rejections are more common than most people think, and usually for reasons that policyholders could have prevented. In this blog, we break down the real reasons why insurance claims get rejected, and how you can avoid them.
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1. Non-Disclosure or Misrepresentation of Facts
When applying for insurance, many people skip disclosing medical history, lifestyle habits (like smoking), or other relevant details. Insurance is a contract based on trust. If the insurer finds discrepancies during claim evaluation, they can reject the claim outright.
2. Lapsed or Inactive Policy
If you miss premium payments, your policy can lapse. A lapsed policy is inactive, which means any claims made during this period are automatically void. Many claims get rejected simply because the policyholder wasn’t aware that their policy had expired.
3. Delay in Filing the Claim
Time is critical. Whether it’s a health emergency or a death in the family, insurance companies have deadlines for submitting claims. Delays can lead to rejection, even if the claim is valid.
4. Excluded Conditions or Treatments
Every insurance policy comes with a list of exclusions. These are specific situations or treatments the policy does not cover. Many health and motor insurance claims are denied simply because the issue falls under an exclusion clause.
5. Incorrect or Incomplete Documentation
Missing paperwork, wrong claim forms, or incomplete medical reports are common reasons for claim rejection. Insurers need proper documentation to verify your claim. If anything’s off, it gives them a reason to reject.
6. Claim Made During Waiting Period
Health and some life insurance policies have a waiting period at the start. If you file a claim during this time, it’s usually rejected. Always check your policy’s waiting period before filing.
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Final Thoughts
Understanding why insurance claims get rejected can save you from unnecessary financial losses and stress. Most claim denials are preventable if you’re aware of your policy terms and follow procedures carefully. Keep your documentation in order, disclose everything truthfully, pay your premiums on time, and know your policy inside out. These small steps can make the difference between a smooth claim and a frustrating rejection.
