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Cashless Health Insurance Claims May Get Rejected

In a stress-filled world where lifestyle diseases have become the new common cold and fitness levels are on the low, it is mediclaim policies that come to our aid during unforeseen medical emergencies.

However, what nobody wants to see is their health insurance get rejected, especially a cashless one. Not only will we have to cough up the money for the medical bills on our own but it defeats the purpose of paying all the premiums.

To avoid such a scenario, here are four reasons you should be aware of when your cashless health insurance will face rejection.

  1. Policy is not live on the date of claim

It is very important to keep a track of when your health insurance policy expires. Most health policies are annual contracts and have a defined start and end dates. You should ensure you pay the renewal premium 30 days before your renewal date to ensure there is continuous coverage without any break. If the policy is not renewed and there is a cash less request after this date, then the claim will get rejected immediately.

 

  1. Pre-Existing Diseases Clause

There are two scenarios when this clause will lead to claim rejection.

  • Ø Firstly, you do not disclose a pre-existing disease at the time of buying the policy.
  • Ø Secondly, the waiting period for pre-existing diseases hasn’t expired. Most insurers’ time range is between two to four years.

It’s best to search for plans with the least waiting period and disclose all details about an existing disease at the time of buying a policy.

 

  1. Coverage

All medical policies have a list of diseases and illnesses which they do not cover or have a specific waiting period before they do. If you file a claim for any of the diseases mentioned on the list, the insurer will reject your claim.

 

  1. Incorrect Form Submission

When you file a cashless claim, there is a certain process you need to follow. It ranges from filling the claim form to attaching relevant documents and more. If there is an error from your side during the process and the insurer sees this and cannot verify your application; it’s a claim rejection.

Now that you know these reasons, be mindful, and ensure your cashless health insurance does not get rejected.

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