Claim Rejection 101: Reasons Why Your Insurance Claim Might Get Denied

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Dealing with insurance claims can be like going on a rollercoaster, full of ups and downs and surprises. Insurance claims offer several benefits and financial aid during unfortunate times. You might know your policy, but rejections can be confusing and frustrating. However, understanding why insurance claims get denied and what you can do about it is also necessary. Today, in this blog, we will explore the reasons for claim denial and offer you tricks to tackle unexpected claim rejections.

1. Not Understanding Your Policy

The primary reason claims get denied is due to a lack of understanding of what the policy covers. Insurance policies are filled with complicated statements and need help understanding. It is essential to understand important details regarding coverage limits, deductibles, and exclusions. If you have any difficulty understanding your policy, you can try the “Know Your Policy” feature by Insurance Samadhan. They have a team of experts from the industry who are masters in decoding any policy and can provide you with an explanation of your policy.

 2. Filing Claims for Non-Covered Services

As mentioned in the first point, it is to be noted that a claim request for service or damage that is not covered by your policy will be denied. 

3. Late Claims Submission

Most insurance policies have a specified timeframe within which you need to file a claim after an incident occurs. Failing to submit your claim within this period can lead to denial. 

 4. Incomplete or Incorrect Information

Most claims are rejected due to errors or incorrect information. These errors can range from misspelling your name to not providing enough evidence to support your claim. Make sure to recheck your claim request form and submit all the required documents.

5. Not Paying Premiums on Time

Insurance is a two-way street. Just as you expect your insurer to support you when you file a claim, your insurer expects you to pay your premiums on time. If one fails to pay premiums on time can lead to a lapse of policy or rejection of a claim due to lack of coverage. 

6. Suspected Fraud

Always prioritise honesty and provide accurate information to your insurer. If they find out you’ve been dishonest when you make a claim, it could get denied. Also, don’t forget to tell them about any existing health conditions you have. Being upfront about everything is essential for a hassle-free insurance process.


Insurance Samadhan specialises in offering guidance and expert advice for claim rejections. Understanding why insurance claims are denied is crucial; it helps policyholders navigate this process. Policyholders can improve their chances of claim approval by being informed about policy coverage and minimising errors while filling out forms. With Samadhan’s support, policyholders can confidently address Insurance claim rejections, knowing they have expert assistance to overcome challenges.

Here’s one of the similar cases that Insurance Samadhan has resolved, involving a claim rejection:

Rajesh faced a challenging situation when he fell ill and needed money for his treatment. Despite submitting a claim, it was rejected on the grounds that he failed to provide certain documents within the timeframe.

Feeling disappointed and unsure what to do next, Rajesh heard about Insurance Samadhan, a place that helps people understand their insurance problems and find solutions. He registered on the official website of Insurance Samadhan, hoping for guidance.

At Insurance Samadhan, Rajesh explained his situation. The team listened carefully and understood his concerns. They explained to him that sometimes insurance claims get rejected because of small mistakes, like missing documents or not following the proper procedures.

Insurance Samadhan guided Rajesh through the steps he could take to resolve the issue. Our team of experts helped him better understand the terms and conditions and advised him on how to go ahead with filing a claim again. 

Rajesh followed the advice and tried again. With better knowledge and understanding of the process, he resubmitted his claim. After a while, he received good news – his claim was approved! 

He got the Rs. 3 lakhs he needed for his treatment. Rajesh felt relieved and realized that with the right help and understanding, even the most challenging situations could be overcome.

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Also Read:  What to Do When Your Life Insurance Claim Settlement is Delayed

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