The decision of taking a life cover and health insurance policy was a very crucial one for Rajesh. He had opted for a life cover early in his life and he was happy with his decision too. However, he didn’t really anticipate that any problem would arise in the future as far as the claim for the policy goes. When he actually made a claim, a number of issues regarding the settlement came up and he ended up getting a lot less than what he should have. Even though he couldn’t change anything, he took a lesson from the incident and made sure that he would advise everybody to analyse the life cover carefully beforehand so that all kinds of claim related issues can be evaded. There is hardly anyone who likes to go through the insurance policy fine print. However, the significance of reading all the terms and conditions before signing the agreement is immense. We all tend to select an insurance plan that offers the lowest premiums on a monthly basis.
Why do the claims get rejected?
This decision impacts your entire life and so one should not simply think of the short term benefits but rather pay attention towards the other crucial aspects as well. Lack of knowledge regarding the health cover is a major reason behind the rejection of claims. We keep paying the monthly premiums and hardly look at other crucial aspects such as the market trends related to the policy, which banks are offering better deals and how does the policy benefit you in the long run. Know everything about the type of plan you have and the benefits associated with it. You must also keep a track of the exclusions and inclusions of the policy so that you know what all things are covered under the policy.
Digging out the legal paperwork
In order to scrutinize and evaluate a life insurance cover , you’ll first need to dig out all the paperwork related to the policy. Go through your medical bills, prescriptions and doctors’ visits in the past few years to apply for life cover in an informed way. Talk to the previous insurers about their claims history so that you have a better idea regarding the claims procedure.
Stay alert while handling partial policy payments
Several policyholders don’t really pay attention to the terms of the policy which state that there is a limit to specific expenses. For instance, the insurer will pay only a part of the expense for a particular treatment and the rest of the amount is to be paid by the insured. When you go for a medical treatment, a number of charges are associated with it and not all of them are covered under the policy. So, it’s crucial for you to know the items that you’d need to pay out you’re your pocket. It will help you in being prepared for what’s coming your way.
Delay in the claims’ procedure
There are a number of documents associated with your life insurance cover and you’ll have to present them all before the insurer when you plan to make a claim. Any failure to present all such documents will result in an unwanted delay. Moreover, missing crucial documents is one human error that everyone would want to avoid. Some of the TPAs working with the insurer usually deny the claim in order to fulfill their targets on a monthly basis. So, it’s essential for you to put your best foot forward so that your life cover claim cannot be denied under any circumstances. Even if your policy gets cancelled, you should be aware of the amount of refund you are entitled to receive.
|Period On Risk||ICICI Lombard (Premium Refund)||Star Health (Premium Refund)||Bharti AXA (Premium Refund)||Tata AIG Insurance (Premium Refund)||Religare Health Insurance (Premium Refund)|
|Up to 1 Month||75%||75%||75%||75%||75%|
|Up to 3 months||50%||50%||50%||50%||50%|
|Up to 6 months||25%||25%||25%||25%||25%|
Rates as on 24th Feb 2014
What about the out of the pocket expenses?
When paying heavy premiums, we don’t really pay attention towards the other expenses that we have to bear annually. A life cover or health cover doesn’t come cheap and an insured needs to spend a lot of money in addition to the premiums which can really take a toll on the savings. Knowing more about deductible, coinsurance and copayments will help you in keeping these out-of-the-pocket expenses under proper check.
When you are new to the insurance industry, sticking to the rules and basics is the key thing to do. Keep your eyes open while paying premiums so that your money and time do not go in vain in the form of a denied insurance claim.