Can claims be rejected?

Spread the love
Can claims be rejected? | InsuranceSamadhan

Transcription of the above video: Can claims be rejected?

Hello, Shailesh from Insurance Samadhan. This time I wanted to take on some different topics. The purpose of our company is to provide Insurance related information to our customers and address their grievances. Insurance Samadhan is a grievance redressal platform that aims at resolving your complaints and we try to raise the forums on different levels in order to resolve your problems. 

I was going through an article where I was reading “Why claims get rejected in Term Insurance”? I have been watching videos regarding this issue and thought of clarifying it to our customers as well. 

It is to be noted that Insurance is a contract. You are supposed to give all the necessary information on the day you insure your policy. You are required to mention in the proposal form your drinking and smoking capacities if you’re into it. The proposal form can be selected on two factors – Standard rates and revised rates. If they have accepted your proposal, then it gets applied from day 1. If you are an adventurous sports player or a driver by occupation, you must mention this information in the proposal form and the claim would be given to you. 

The claim can be rejected in only one condition which is, suicide in the first year of the policy. Other than that, no claim can be rejected if you’ve given the declaration from your end. 

Now, there is section 45 in Insurance which states that a company can reject the claim for three years, considering that the customer has not declared at the time of proposal and had hidden facts from the company. These facts include hiding about the drinking and smoking habits, occupation, playing adventurous sports, and many more. This rule does not apply after a period of three years. After three years, the company is bound to give a claim under any condition. If the company is not giving you a claim, then in that case they can ask you to prove your declaration is not being hidden from them. So, you must be in a position to prove yourself right. Also, there is one more condition applied, which is, you do not have any drinking possessions at the day you’re insuring policy but after one year, you started drinking and smoking, in such a case, you’re liable to receive your claim. 

Also Read:  Cashless vs Reimbursement in Health Insurance and how to manage Claim Rejections

Therefore, you must be knowing all this information to fight out your claim. You can always approach Insurance Samadhan to solve your Insurance related queries and we would be more than happy to help you out!

Thank you. 

Leave a Reply

Your email address will not be published. Required fields are marked *