Four Tips To Avoid Health Insurance Claim Rejection

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In the pandemic era, health insurance is one of the most important protections that one needs to have for self and family. Health insurance provides financial support to the insured by covering expenses incurred during consultation, hospitalization, and surgical and non-surgical procedures. On the flip side, health insurance claims may get rejected by the insurance provider, which can lead to confusion, distress and bitterness. This can be avoided by being mindful of four factors while purchasing a medical insurance policy.


Get a comprehensive policy

Insurance is all about ensuring the wellbeing of the insured and their loved ones by minimizing risk. In the case of a health emergency, the last thing anyone wants to worry about is how they will pay the medical bills. In order to be better prepared for such a situation, it is advised to get a plan that offers ample coverage. This means at least INR 3 lakh of sum assured, and more if you live in a metro city where medical expenses are higher as compared to tier II or tier III cities.

Choose a cashless hospital

If you or your family member has to undergo a medical procedure for which there is ample time to plan beforehand, go for a cashless facility that is in your insurer’s network. Rates at such institutions are pre-negotiated, and hence may be pre-authorized by the insurer. In case the procedure is urgent and you are unable to plan in advance, be wary of the hospital room you pick, since it has a major impact upon the cost of the procedure. When you walk into a hospital, gather all the information you can about the room rent charges you have on your insurance plan. You can always reach out to your insurance partner in case there is any confusion.

File the claim with caution

More often than not, minor errors in the claim filing documents result in claim rejections. Around 60 per cent of rejections are a result of people sending in wrong, incomplete or insufficient documents. Double check all the information you are filling in while filing your medical claim, and make sure you are attaching all the requisite documents.

Find an ally in your health benefits partner

If you have roped in a good insurance broker or agent, they can reverse a reimbursement decision.