Insurers reject a minority of claims, but the reasons are remarkably consistent — and almost all of them are within the policyholder’s control.
1. Non-disclosure at proposal
An undeclared condition, habit or existing policy. This is the single largest category by a wide margin. Disclose everything, even what seems irrelevant.
2. Claiming during a waiting period
Know your initial, specific and pre-existing waiting periods before you need them.
3. Late intimation
Policies specify notification timelines. For planned hospitalisation, notify before admission. For theft or accident, notify immediately and register an FIR.
4. Missing originals
Reimbursement claims need original bills, discharge summary and reports. Photocopies stall files.
5. Letting a policy lapse
Cover stops when the grace period ends. Set reminders, or use long-term policies where available.
6. An outdated nominee
An incorrect nominee turns a straightforward payout into a legal problem for a grieving family. Review it annually.
If a claim has already been repudiated, there is a grievance and ombudsman route. We help clients through it.