What are the reasons for claim rejection?

A claim can be rejected in any of the following situations-

1.Insurer can reject the claim if the policyholder has some pre-existing disease which was not disclosed during the policy term. If the claim is made on that ailment, it can be rejected.

2. Insurance company may also deny claims if documents submitted by the insured are incomplete.

3. As per health policy terms & conditions, an insured should inform the insurance company within 48 hours of hospitalization. Any failure to abide by deadline would result into claim rejection.

4. Insurance company has a right to reject the claim if the pre-authorization form is not carefully filled or if there is a discrepancy in the information, like incorrect postal address, policy number, etc.

5. Claims may be denied if it is for those ailments which are not covered in the policy.