UB AND COMPANY's video: Pre-Existing Diseases ped healthinsurance reject india lic

Claim rejection due to pre-existing diseases is a common issue that policyholders may encounter with their health insurance. Insurance companies have specific guidelines and waiting periods related to pre-existing conditions, and if these conditions are not met, the insurer may reject the claim. Here are some reasons why health insurance claims related to pre-existing diseases may get rejected: Non-disclosure of Pre-existing Diseases: When applying for health insurance, individuals are required to provide accurate and complete information about their medical history, including pre-existing diseases. If a policyholder fails to disclose a pre-existing condition or provides false information, the insurer may reject the claim, citing non-disclosure as a breach of policy terms. Waiting Period: Most health insurance policies have a waiting period for coverage of pre-existing diseases. If a claim is made for treatment related to a pre-existing condition during the waiting period, the claim is likely to be rejected. Policy Terms and Conditions: It's essential to understand the terms and conditions of the health insurance policy. Some policies may have specific exclusions related to pre-existing diseases or may limit coverage for such conditions. If the treatment is not covered under the policy, the claim may be rejected. Incorrect Information: If there are errors or discrepancies in the information provided on the claim form or supporting documents, the insurer may reject the claim. Lapsed Policy: If the health insurance policy has lapsed or is not active at the time of making the claim, the insurer will reject the claim. Exceeding Sum Insured: If the cost of treatment for the pre-existing condition exceeds the sum insured or the coverage limit specified in the policy, the insurer may reject the claim for the excess amount. Inadequate Documentation: Insufficient or inadequate documentation to support the claim can lead to claim rejection. To avoid claim rejection related to pre-existing diseases, it's crucial to be transparent and truthful while providing information during the application process. Read the policy terms and conditions carefully to understand the waiting periods and coverage limitations for pre-existing conditions. Keep the policy active and pay premiums on time to ensure continuous coverage. If you have a pre-existing condition, it's a good idea to inquire about policies or riders that specifically cover such conditions or have shorter waiting periods for coverage. Additionally, maintaining a good relationship with your insurance provider and promptly providing all necessary documents and information during the claim process can increase the chances of a successful claim settlement.