Reason Why Your Cashless Health Insurance Claims May Get Rejected

Given the kind of hike quality medical insurance is seeing, it is vital for all at least to get a basic health insurance cover. It will not only help...

Given the kind of hike quality medical insurance is seeing, it is vital for all at least to get a basic health insurance cover. It will not only help when a medical emergency strikes you but is also handy when any member of your family is ill.

However, when you get started with the claim settlement of your policy and if it gets rejected when you need money the most, the purpose of availing one will fail.

Thus, it is vital for you to know some valid reasons that may reject your cashless health insurance claims. Let’s know some major cashless health insurance claims rejection reasons:

  • An incomplete form

When you don’t fill the form correctly and leave some information blank or provide any invalid information, then your insurance service provider may not pass the claim. Thus, ensure to provide only complete and updated information in your claim settlement form so as to get the green signal from the insurer.

  • When you ask for a claim not included in your policy

If you go ahead and ask for any claim which is not included in your health insurance policy, then the insurer may reject your claim outright. Thus, make sure to apply for a claim against only those ailments that are covered by your medical insurance.

  • Procedure or diseases not covered by your policy

Although some of the insurance service providers may have a standard claim submission process, some may not have the same. What one company may follow as the procedure to apply for a claim may not be the same by an insurance company. Thus, take efforts to talk to the representative of the company and know their claim submission procedure. Also, asking for a claim against diseases not covered in your policy may also see your claim getting rejected by your health insurer.

  • Not applying in the nick of time

Unless you don’t apply for the cashless health insurance claim in the nick of time, you may see it getting rejected by your service provider. If you don’t inform your service provider about the admission of a policyholder in a hospital within 24 hours, there will not be claim approval coming your away. You can let your immediate family members inform the insurer about your service provider as many times, you may not be in a position to inform yourself.

  • If the procedure was deemed not required

One of the other most collective reasons for the rejection of the cashless health insurance claim is when a procedure or service is deemed ‘not medically vital’ by your health insurance company. The common trend in private hospitals is to put a patient through a chain of unnecessary tests to get maximum revenue. This is done in the name of ‘ruling out all possibilities’ of ailments. Knowing what you can claim and what not under your insurance policy and not including them in your policy is vital. It also becomes tough to believe if a specific test is required or not and hence, keeping them off may be tough.

The Bottom Line

The major reasons for your cashless health insurance claim tour are now listed for your reference. You can now be in a comfortable situation to ask for a claim and don’t see a rejection hitting your straightaway. All the best!

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