WHY HEALTH INSURANCE CLAIMS ARE REJECTED
Why can your insurance claim get rejected & how to avoid it?
All health insurance policies have a life-long renewal clause which the regulator has mandated. They cannot be rejected and your pricing cannot go up purely because you have a condition right now. So, certain benefits are inbuilt and benefits that the customer can take, says Deepak Yohannan, CEO, MIC Insurance Web Aggregator
Budget 2024 Section 80D Exemption: Why govt should increase Section 80D tax exemption limit for health insurance under old tax regime
Budget 2024 Section 80D Exemption: Taxpayers who have opted for the old tax regime are hoping for an increase in the limit under section 80D in the upcoming July 2024 budget, considering the significant rise in healthcare costs.
Nearly 70% health claim users opting for reimbursement mode don't have enough liquid savings to pay bills: Survey
A recent study highlighted challenges faced by health insurance policyholders opting for reimbursement, often resorting to borrowing or dipping into savings for medical bills. Despite expanded coverage, 68% lacked adequate savings for expenses. Cashless treatment remains preferred, with 89% satisfaction, compared to 79% for reimbursements. Delays post-discharge also impact satisfaction.
Is your medical claim stuck? Find out why you face problems in health insurance claim settlement and how to avoid them
While health insurers can sometimes be blamed putting customers through unending hardship in clearing claims, many a times it’s the policyholder who is at fault. A significant portion of these health insurance claim rejections can be prevented by asking the right questions during policy selection, carefully reviewing policy documents, and conducting thorough research. This article explores common health insurance claim rejection scenarios and explains how to avoid them.
6 questions to ask while buying a health insurance policy to avoid claim rejections later
How to buy the right health insurance policy that will pay for your claims on time? You can avert claim rejections by asking the important questions at the time of buying health insurance and reading the policy details and fine print carefully. Ask these questions while purchasing a health plan or at the time of filling a proposal form.
6 recent health insurance claim rule changes every policyholder should know
Insurers will have to clear a health insurance claim within three hours of receiving it from the hospital during discharge. Irdai has also given a window of one hour for clearing cashless claim requests at the time of admission. All you need to know about the recent health insurance claim norm changes by the insurance regulator.
Star Health looking to grow 18%, improve claims ratio by 50 bps: Anand Roy, CEO
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Health insurance premiums can be reduced if you don’t make a claim, policy cancellations to be less costly and more: 5 rule changes
Health insurance rule changes: To make health insurance policy more inclusive, flexible and customer-friendly, IRDAI has recently released a master circular on health insurance business. The regulator introduces new measures regarding cancellation charges, standardising no-claim bonus, and increasing claim settlement transparency. ET Wealth Online explores how these regulations empower policyholders and improve their health insurance experience.
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I will highlight two-three points over here. One is definitely a size advantage that a Quant would have, so I am talking about a thousand crore fund versus a 35,000 crore fund, so that helps in the agility of the fund manager to actively manage.
Improvement in tech, backend processes & team strength needed to achieve IRDA objective: Shweta Rajani
It is welcoming move what IRDA has done because it now means that one within three hours in a normal case the insurance company has to authorize the entire documentation and the claim approval has to go through, not only that they are also emphasising that there should be a 100% claim and any claim rejection by the insurance company would internally need internal explanations and approvals.
Health insurance claim rule change: Cashless claims must be cleared in 3 hours; insurer to pay hospital charges for delay in discharge, says IRDAI
Health insurance: The Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular to streamline health insurance claim process. Previously, delays in claim approvals forced patients to stay in hospitals longer. Now, insurers have three hours to approve cashless discharge requests. Additionally, insurers will be liable for extra hospital charges due to delays.
Empowering senior citizens: The crucial role of health insurance in India
Recent IRDAI regulations in India aim to empower senior citizens through accessible health insurance options, including coverage for Ayush treatments, aggregate deductibles for cost-sharing, and comprehensive rider packages for additional benefits. Assessing needs and selecting the right plan are essential for personalized and comprehensive health coverage.
Health insurance claim rejection: Widow fights, wins Rs 28 lakh damage; pre-existing disease can't be free pass for claim denial
The Delhi State Consumer Commission ruled that an insurer cannot reject a health insurance claim solely based on pre-existing diseases if they weren't the cause of death. The commission directed HDFC Life (previously known as HDFC Standard LIC Co. Ltd.) to pay Rs 19.4 lakh along with the interest to a woman whose husband's claim was rejected for not disclosing diabetes. The insurer also has to pay Rs 1,00,000 for mental harassment of the complainant along with the litigation cost. This is a relief for those with common lifestyle diseases like diabetes. Read the full case and verdict in details. What do you need to keep in mind while buying health insurance policy to avoid claim rejection later. Find out here.
Health Insurance Claim: 43% policyholders faced difficulties, some had to wait an extra day at hospital, survey
Health Insurance claim: Many people in India are facing difficulties in getting their health insurance claim processed. "43% health insurance policyholders who filed a claim in the last three years struggled with getting it processed," as per a report by LocalCircles.
Health insurance rules changed for senior citizens: Be ready for a 10-15% hike in health insurance premiums
In a major reform, Insurance Regulatory and Development Authority of India (IRDAI) has removed the ceiling of 65 years for a person to buy a health insurance policy. Additionally, the waiting period for pre-existing conditions has been reduced from four to three years. Both these rules have been effective from April 1, 2024. Will these new rules help uninsured senior citizens get health coverage? How easy is it now to buy a health insurance policy for the first time at the age of, say, 70? Find out here
Don't have insurance? Be ready to pay up to 10% more at hospitals; here's why
Fortis Hospital Gurgaon's billing practices revealed a 27% bill increase for self-paying patients. Investigations by Times of India uncovered discrepancies in billing for self-paying and insurance-covered patients, showcasing the hidden disparity in healthcare costs.
Latest health and general insurance claim settlement ratio released in 2024
Do you know how good is your insurer is in settling claims and how long it takes for your health or general insurer to settle claims? Or how many claims did they reject last year? It is important to keep track of the claim settlement performance of your insurer. IRDAI has recently released the claim payment details of general and health insurance companies. Check here
Husband wins Rs 1.57 crore health insurance claim against LIC after a 5-year fight
LIC health insurance claim: Life Insurance Corporation of India (LIC) was ordered by NCDRC to pay Rs 1.57 crore to the husband of deceased policy holder who died from Breast Cancer in 2017. The said policy was approved by LIC in 2016 after eco and medical tests were done by the policyholder.
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