Buying a health insurance policy is one of your most important investments. It relieves you of your financial burden during critical situations, like medical emergencies. The one aspect which the policyholders look for in a health insurance policy is the claim settlement process of the insurance company.
Many insurers, like Bajaj Allianz General Insurance, offer cashless claim facility at network hospitals. However, if you are admitted to a non-network hospital, you can register your claim with your insurer and get the amount reimbursed in your account. But what if your claim is denied by your insurer?
Insurance companies always try to settle your claim, but as a policyholder, you should be proactive enough and avoid the denial of your health insurance claim.
What to do if your health insurance claim is denied?
It is very unfortunate if your claim gets rejected/denied by your insurer. But there are certain ways which give you an opportunity to understand why the claim was denied and what next steps you should take to appeal against the denied claim. One thing that you can do is take recourse under the Grievance Redressal procedure stated under your health insurance policy.
There are usually three major reasons based on which your insurance company might reject your claim:
Here are some ways to deal with denied health insurance claims:
You can appeal the denied insurance claim multiple times, but we recommend that you understand the complete details of your insurance policy and the reasons provided by your insurer for the rejection of your claim. If you are appealing against a right decision of claim denial, then you might be losing a significant amount of time, energy and money from out of your pocket.
We at Bajaj Allianz have the highest claim settlement ratio among private insurers. Check out the features and benefits of our various health insurance products on our website.
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