Insurance claims can be rejected by insurance companies;
this condition becomes a scourge for insurance owners. In fact not
infrequently, people become reluctant to buy an insurance policy because of
fear of difficulty in filing insurance claims.
In fact, there is a reason why insurance claims seem
difficult. One is to prevent the occurrence of fraud or criminal acts in
insurance. Even so, if you understand all the agreements written in the
insurance policy and have a complete document, do not worry your policy will
run smoothly.
In general, here are seven things that cause insurance
claims not paid:
1 / Polis or rider is off (lapse). This usually happens
because the policyholder does not make the payment after the grace period for
30 days from the due date of payment so the policy is no longer valid (grace
period).
2 / claiming a claim before the waiting period can certainly
cause a claim to be rejected. It is stipulated in the policy agreement.
Different waiting periods on health insurance and critical illness insurance.
For critical illness, there will usually be a waiting period of 30 days up to
365 days.
3 / Early exclusion of the policy or rider, such as hiding
the health condition experienced before the purchase of the policy even though
it has passed the waiting period. Even if the waiting period has elapsed, if it
is proven that the disease has actually been experienced since before taking
the policy, the insurance will refuse his claim. So make sure you are still in
good health when buying insurance.
4 / the policyholder violate the law. For example the
policyholder has an accident for violating traffic rules. This condition can
lead to insurance policy claims denied.
5 / Fraud action or insurance crime by the policyholder or
his heirs to obtain sum insured by intentional means. For example, the
policyholder intentionally injures himself, or the heirs commit a crime against
the policyholder. This condition will automatically lead to automatic rejection
of claims.
6 / the insured dies due to suicide, the death penalty by a
court, a crime, an act or an attempt to violate the law.
7 / As for risky occupations, sports or dangerous hobbies,
if stated at the earliest before the insurance policy is approved, there is
still the possibility of a claim to be recognized. Depending on the initial
agreement the policy is submitted
