Things to Do After Your Insurance Claim is Rejected

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Insurance is bought to enjoy a secure future, but sometimes due to some unknown reasons, the claim can get rejected, in that case, there are several ways to solve the problem.

Reasons for the rejection of your insurance claim:-

There could be many reasons as to why the claim was rejected –

  • Wrong information is one of the most common reasons. Giving incorrect information about damage or improper information could easily lead to the rejection of the claim. Before giving a green signal, insurers first ensure that the information about the damage parts was true or not. They have people to check for it and if a green signal is not passed on then the insurance company rejects the claim.
  • If you lost your insured product or damage was brought due to ill-care then also the insurance claim is rejected under the policy terms.
  • While filling up of the application, if you have not mentioned about the medical condition, which was before taking the insurance policy or any past criminal offence in your name and if that comes into their knowledge then they can reject the claim.

Then also, if somehow you are not satisfied and feel that the reason is not good enough then you have several other ways to address the situation.

Steps to take to reclaim your insurance policy:-

Examine the policy documents carefully

See thoroughly whether you gave all the details carefully or missed anything in between.

  • Highlight the words wherever it clearly says that your insurance is covered. You may need it later for reference. Also keep a picture of it with yourself, so that in case of any paper missing you can always have a copy of the document.
  • Insurance companies’ main task is to clear all the terms of policy, rules and regulations to their customers. Not only make them understand well but also have a document stating every terms and condition. If you find any condition ambiguous, duly note it down, highlight it and keep a copy.
  • According to new rules if the insured has answered all questions truthfully and honestly then the insurers are not liable to reject the claim. But in case if the insurance company has not asked for any reason then at the time of rejection they will say that the insured should have passed the information voluntarily.
  • If in case you send the letter to the insurance company stating a change in the circumstances, then find a copy of it and keep it safe.
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Contacting the insurance company

Once you have thoroughly checked the policies and have enough proof in your favour then the next step is to contact with the help centres or complain handlers of the insurance company. You can either directly call them and lodge the complaint or write a formal letter to the specified complain handler.

Steps to writing a formal letter:

A formal letter is the most crucial and important part as the letter should contain all the necessary information with relevant proof and at the same time, it should also be concise and to the point.

  • Add policy number and your name correctly.
  • Give the subject such that it quickly catches the eye.
  • State all the problems related to it.
  • Attach evidence to support the complaint.
  • Do inform them about taking the case to Financial Ombudsman Services if you are not satisfied with their reasons.

After writing the letter, do not forget to make a copy of it for future reference.

Financial Ombudsman Service

Even if you are not happy after getting a response from the insurancecompany, then also you can approach the Financial Ombudsman Service. It is a free service that works independently to investigate any complaint made from an individual about financial service companies.

They investigate thoroughly through every document and listen to both sides of the story to have an unbiased opinion.

If they found any fault of the insurance company then they have the authority to ask for a reasonable explanation from the company and the insurer is bound to answer. They will also make them apologize for their mistake and ask to pay the compensation along with bringing change in the outcome.

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Before the case is referred to the Ombudsman, it first goes through an independent assessment known as ‘adjudicator’.

You have taken the insurance and made an investment in it keeping the future possibilities in mind, and if any company stops you from claiming it without giving any proper explanation then you should not sit back and moan about it. You have all the rights and ways to get back to them with just simple steps. All the processes may take a little time but eventually, you may get what you deserve.

Shailesh Kumar

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