6 Reasons Why Insurance Companies Might Reject Your Claim

 

When you buy an insurance policy, you expect that in your difficult times the insurance company will help us financially. But what if the claim gets rejected at the time of loss??

When a loss occurs, you need to send an intimation to the insurance company with the policy form and the necessary documents. Subsequently, the insurance company will investigate such a claim and thereafter, decide whether to approve the claim or deny it. If your claim gets approved, the company will pay the amount to the insured or the beneficiary. However, if your claim is rejected, then the company will send you a claim rejection notice wherein they will mention the reason for the insurance claim rejection.



Reasons for Insurance Claim Rejection

1.   Concealment of Facts: If you have not disclosed your correct information, which might affect the level of risk involved in insuring such risk, then the insurance company can reject the claim.

2.     Suicide: Claim is not payable if death has happened due to suicide in first year of policy commencement or reinstatement.

3.     Non- payment of Premium: If you forget to pay premium even after the grace period, then the company can reject claims.

4.     Pre-health check-up: It is better to do a pre-health check-up before taking a policy so that your health status can be known to the insurance company. If you have avoided such a health check-up, the company may state it is a pre-existing disease and you have intentionally concealed it. Further, reject the claim.

5.    Incorrect information of Nominee: The Company can reject the claim on the grounds of incorrect nominee details if you have forgotten to update it. There are cases where people failed to mention the nominee name in the policy document.

6.   Exclusion: When terms and conditions of the policy states that the reason for claim is excluded from the insurance policy, then the company can reject the claim.

After understanding the reason behind claim rejection, you may resend a claim notice to the insurance company with the proper documents and explanation. 

If you are still dissatisfied and feel that your case is genuine, then you can take help from IRDAI- Insurance Regulatory and Development Authority of India for your grievance redressal and lodge your grievance with the Grievance Cell of IRDAI.

How to register a complaint with IRDAI?

1.  You can register on IGMS- Integrated Grievance Management System. It is an insurance grievance redressal of IRDAI. Do remember to check the status of your complaint.

 http://igms.irdai.gov.in

2.     You can also lodge your complaint by sending an e-mail to complaints@irdai.gov.in

3.     You can also call on a Toll Free No. 155255 or 18004254732

4.     If you want to send a complaint letter in a physical form, then send it to IRDAI.

 

Address:

The General Manager

Insurance Regulatory and Development Authority of India (IRDAI)

Consumer Affairs Department - Grievance Redresaal Cell.

SyNo. 115/1, Financial District, Nanakramguda,

Gachibowli, Hyderabad- 500 032

You can also contact Insurance Samadhan. We provide customers a platform to raise their insurance-related complaints and then we work together with you to resolve the issue. 

You can 

Register yourself on our website- https://www.insurancesamadhan.com/

Email us: corporate@insurancesamadhan.com

Whatsapp us: +91 9910998252

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