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Insurance Claims: Alert! Insurance claim gets rejected, know the reason, will help in getting the claim passed

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Insurance Claims: Health insurance claim may be rejected due to these 5 reasons, do you know?

It is very common for insurance claims to be rejected. The biggest reason for this is that people do not read the terms and conditions carefully while buying the policy.



Getting an insurance claim rejection is not a new thing. Passing the claim becomes a tedious task due to the terms and conditions of the insurance. This issue has come to the fore again after HDFC Ergo recently rejected a claim. However, while taking insurance, some things should be kept in mind and precautions are taken, then the problem of claim rejection can be avoided to a great extent.

Claim rejected due to motorcycle exceeding 150cc

The reason behind the rejection of insurance claim related to death in a bike accident is interesting. HDFC ERGO, while rejecting the claim, has said in this case that the person concerned was riding a 346 cc bike, hence the claim cannot be passed. HDFC ERGO has cited exclusion clause 8 of the terms and conditions of the policy to state that in case of an accident involving a motorcycle or scooter of more than 150 cc, the claim cannot be passed. Let us know, what precautions need to be taken while taking insurance and making a claim.

It is necessary to read the terms and conditions thoroughly

Generally people do not read the terms and conditions while taking an insurance policy. Companies add many such conditions to it, about which you are unaware. Before taking a policy, it is very important to read and understand all its terms and conditions thoroughly. Don’t depend on the agent for this. Now many online portals are providing policy details. You can also compare one product with other products on these portals.

Claims are also rejected due to the method of definition

Definition is the main reason for claim rejection. The way you define an issue, the insurance company defines it differently. Like if you have got theft insurance in the house. Now if any member or staff of your house stole, then in this situation your claim can be rejected. Insurance companies pass claims only in cases of theft, in which there is solid evidence that the incident was carried out by forcibly entering your home with the intention of theft.


Know the terms about pre-existing diseases

In the case of health insurance, the biggest reason for rejection is pre-existing diseases. Insurance companies can also reject your claim if you had a pre-existing disease and you did not inform the company about the same at the time of taking the policy. While taking health insurance, it is important to check the pre-existing illness thoroughly.

Travel insurance claim gets rejected because of this

In the case of travel insurance, the company pays you in case of flight cancellation or delay. However, there are many conditions in this too. If the airline has canceled or delayed the flight due to any natural calamity, your claim will remain valid. If you miss the flight by mistake, the claim will be rejected.

File a claim immediately after the incident

Sometimes the reason for rejection of claim is the delay. While making a claim it is important to keep in mind that the longer the delay, the higher the chances of getting rejected. Insurance companies generally give seven to 30 days to file a claim. An effort should be made to make a claim immediately after the incident to avoid unreasonable claim rejection.


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