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Insurance Company Paid Only Part of the Claim: Can the Policyholder Dispute the Deduction?

An insurance claim may not always be rejected fully. In many cases, the insurance company may approve the claim only partly and deduct a substantial amount. The policyholder may receive a settlement message showing a reduced amount, but the reason for deduction may not be clear. Partial settlement can arise [...]

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Cashless Health Insurance Denied: Does It Mean the Final Insurance Claim Is Rejected?

Cashless health insurance denial creates immediate pressure during hospitalisation. The hospital may ask the patient or family to pay the bill before discharge. The TPA or insurer may say that cashless approval is not possible due to query, incomplete documents, suspected pre-existing disease, waiting period, policy exclusion, non-disclosure allegation or [...]

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Health Insurance Claim Rejected for Pre-Existing Disease: What Documents Can Challenge the Rejection?

A health insurance claim may be rejected when the insurer alleges that the illness was a pre-existing disease. This is one of the most common reasons given in health insurance disputes. The policyholder may receive a rejection letter stating that the disease, symptom, treatment or condition existed before the policy [...]

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Health Insurance Claim Rejected? 10 Things to Check Before Accepting the Insurer’s Decision

A health insurance claim rejection can place a patient and family under sudden financial pressure. The policyholder may have paid premiums regularly, submitted hospital bills and followed the claim process, but the insurer may still reject the claim by referring to policy exclusions, pre-existing disease, waiting period, non-disclosure, incomplete documents [...]

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