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Why Insurance policy claims get rejected?

My friend Sandeep's  Uncle has recently died of heart attack and after that their family members had submitted Application claiming the Sum Assured, But the insurance company rejected their claim showing a standard provision of the insurance policy. I was surprised to hear that !  

what is the meaning of taking a insurance policy which cannot help your family in your absence, But on inquiry in detail I have understood that the particular policy will not pay if the policy holder dies due to a health problem , So it is very important to know the limitations of the insurance policies we take, Here we shall take a look at few other reasons which lead to rejection of Insurance claims

1) Hiding Health Problems will lead to rejection of Insurance claim
If you don't declare a health problem (like blood pressure) you are facing at the time of buying a insurance policy, that may lead to rejection of claim. Most of the times what happens you will ask the insurance agent if a medical tests are required and Insurance agents, Now a days as a marketing technique most of the insurance companies have substituted  medical tests with a health condition declaration form. So you may be tempted to hide the facts to bring down the premium.
image credit : aopsan/

2) Become a Alcoholic after taking Insurance policy
It happens in some cases that, The policy buyer was not a drinker or a smoker at the time of buying a insurance policy, but had developed habit of drinking or smoking at later stages, this should be reported to the insurance company, so that you may need to pay more premium, If you don't want to pay more premium you may have to keep your policy at risk, which may be lead to rejection of insurance claim 

3) You Need to Tell if you have more than one Insurance Policy
It is important that you disclose to the Insurance company at the time of buying regarding any other life insurance policy you have, if you have any? Because some companies and policies may have some limitations regarding multiple policies and requirement of original documents at the the time of submitting the claim, Because both the companies may ask original docs

4) Application Forms filled by Agents for You

Application forms filled by Insurance agents often hide the facts and present incorrect information to the insurance company just to bring the premium down and some times they may leave some columns unfilled, which also may lead to claim rejection at a later stage.

5) Mistakes while filling the Insurance Claim
You should avoid any silly mistakes like not writing proper date of birth or not enclosing age proof documents and or not mentioning about the recent illnesses and at the same time it is important you tell the hospital staff regarding this claim and the insurance company may enquire any time about this, So that they will respond properly to the questions asked by insurance companies

Why Insurance policy claims get rejected? Reviewed by Gowardhan on 12/10/2012 10:23:00 PM Rating: 5

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