Hyderabad: All these years, you have paid premium with an unfailing regularity. Made sure that all your family members are insured. But, when the medical emergency has emerged, the insurance company is not accepting your claim. Whom to blame? Reality is that any small mistake in the health insurance contract will only cause financial loss to policy holder. What to do? Let's find out.
Insurance involves trust between policyholders and companies. This trust factor is applicable only to the terms and conditions in the policy. Most often, policyholders tend to be careless while filling application form. Knowingly or unknowingly, provide deficient information. Common errors prove costly. Those like misspellings in name, misrepresentation of age, smoking habits, non-disclosure of annual income details.
Accurate details about your medical history have to be provided. Many people think that if all the details are told, the policy will not be given and the premium will be charged too much. Even if you hide your health details and take a policy, there will be problems. For example, the policy does not mention smoking. Then the company claims that the policy was taken fraudulently. Tell all details asked about personal health to avoid such things.
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Companies alert policy holders about renewal one month in advance. Some people procrastinate. Generally renewal is possible up to 30 days after expiry. The insurance cover ceases as soon as the policy expires. You will not get compensation if you have to be hospitalized unexpectedly during this uncovered interval.
There is a waiting period of 30 days after taking a new policy. During this time, medical expenses are paid only in case of hospitalization due to accident. Even in case of critical illness coverage, the insured will get the claim only if they survive for at least 30 days after diagnosis. A waiting time of 2-4 years is considered for some pre-existing diseases and compensation may not be available. So, details should be given for such exclusions.
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Before taking a scheme or policy, one should know the terms and conditions in full. All the details in the policy document should be thoroughly checked twice. Every health policy clearly states the terms and conditions under which the insurance is not applicable. Many people ignore this. Eventually, they face difficulties when the claim is rejected. Better to take care in advance than to face such complications in the future.
Another major reason for rejection of medical claim is failure on the part of policyholders to inform the insurance company within the stipulated period. It may not be possible to make a health insurance claim immediately in the wake of an accident or an emergency. However, details should be informed to the insurance company within 24 to 48 hours of hospitalization. Even if the policyholder is not in a position to inform, his nominee or authorized persons should inform the insurance company in time.
