The main reason why we take insurance is to ensure our financial protection, so even if we had to pay for the expenses at that particular moment, you can later claim it from the insurance company by submitting the relevant papers. Your insurance company does justice to you when they process and approve the claim without giving us any burden. But what happens when your insurance is rejected, here are some methods to handle your insurance claim rejection.
Methods to handle insurance claim rejection
- Have a close look at your insurance policy –Carefully read through your insurance policy and have a close look at the clauses involved. At times, you may be applying for a claim, which is not included in your policy and which you may not be aware of. Even for a simple reason, there are chances that your claim can be rejected
- Check all the information – Check if you have filled in the correct details, as a minute error can cause your claim to be rejected. The two important things which need to be checked first are name and policy number, if there are any such mistakes resend the corrected form to avoid claim rejection. Any incorrect or false information mentioned in the policy during the time of taking the policy can also cause for claim rejection.
- Cross check the documents submitted – Put together all the information and check that you have not misplaced any reports or documents or sent the wrong set of files as that can lead to rejection.
- Get in touch with your insurance agent or company – If you feel that all the details and information in your policy is accurate then contact the insurance provider either through phone or write a letter and send it to the complaint handlers seeking their side of the story or justification for the claim rejection. In the letter include your name, policy number, your complaint stating why you think your claim must not have been rejected, evidence and your wish to seek a legal fight if claim is not settled.
- Submitting an appeal – Send an appeal to the insurance company stating your claim denial, including all the relevant details, reports and documents as required.
- Seek legal assistance – talk to a good lawyer explaining your scenario and the claim denial, submit all the evidence and supporting documents. If he/she feels that there is a high chance you can win the case and there is truth on your side then he will guide you on how to move forward with the case and chances of winning the case
- Visit the Ombudsman service – If you still do not find yourself happy then you can visit the financial ombudsman service which is an independent and free service investigating the complaint, they will hear both sides of the story, check the documents and evidence and give a fair result based on their findings.
IRDA Links and Guidelines
If you have grievance, approach the grievance cell of the Insurance Company first.If you are not happy with their solution, you can escalate the matter to IRDA
- How to make a complaint?
- Complaint Logging at IRDA
- Integrated Grievance Management System – By IRDA
- IRDA – Updated list of Life Insurers
- IRDA – Updated list of Non-Life Insurers
- Governing Body of Insurance Council - Insurance Ombudsman
- Insurance Ombudsman Address
Recommended Read :
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- Step By Step Methods to Handle Insurance Claim Rejection
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- How to Handle Denied Life Insurance Claim Rejection Appeal?
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- Possible Reasons for Health Insurance Claim Rejection
- How to Escalate If Your Health Claims Gets Rejected?
- Why Reimbursement is Better Than Cashless Health Insurance?
- Role of TPA in Health Insurance
- Cashless Hospitalisation not always Cashless
- Insurance without Medical Check - Alert
- Common Pre Existing Diseases Health Insurance
- Change Health Insurance Provider without Losing Your Credits
- Minor Repairs Claim Vs No Claim Bonus
- How Many Times Can I Claim Car Insurance?
- Vehicle Modification Insurance Rejection
- How to Claim Travel Insurance?
The claims are rejected haphazardly by giving reasons which the customer is unaware about. The business groups tend to forego ethics while conducting business in the lure of making more money. The vicious circle created by companies to sell policies without disclosing complete facts gives rise to such incidences. The laws should be made more stricter for insurance companies to hinder them from doing such acts.
Insurance is like a friend whose real test is in times of peril. But just imagine how depressed one will feel if this friend or insurance company rejects us in our bad times. But if careful attention is paid while submitting the insurance form and is cross -checked, some of these problems may not arise. Further proper awareness is required on the part of the insurer.
Unfortunately over past few years, before the competition among the insurance company has become very intense a lot of insurances have been paid just for being insured. Claims were hard to have been approved and access to money was quite miserable. However, in years, as the competition become harder, the claims are more likely to be approved.