Taking up health insurance is one of the major ways of safeguarding your finances. Somebody said that an average income earner is just one ailment away from poverty. Going by the opinion cost of healthcare, this assertion is not far-fetched.
With health insurance cover, you can expect that should you fall sick, the hospital bill should be the least of your worries. It, therefore, comes as a huge disappointment and inconvenience when your claim is denied in the hour of need. In this article, we look at some of the reasons why your claim could be rejected.
Table of Contents
Incorrect information
Did you give the wrong information or withhold details that are crucial to your insurance policy? This applies to personal details such as age, income, occupation, dependents, existing insurance plans, and so on.
While you can sometimes give incorrect information by mistake, people often intentionally lie in order to qualify for a certain policy. Age is the most sensitive thing here. The way insurance policies work, the younger you are, the lower the premiums. Some people will claim to be younger than they really are to qualify for cheaper rates. Even when you want to take advantage of price-cut deals such as AAA health insurance discounts, you stand a better chance if you’re younger.
Should the insurer notice that you provided the wrong information, whether by mistake or intentionally, then he’ll be under no obligation to honor your cover.
Pre-existing condition
Did you have a preexisting condition that you were aware of and did not disclose? Then you’ll be included in the category above of people who gave false information. The tricky bit here is that it is possible to live with a certain health condition yet you’re not aware of it. Some ailments take years to be diagnosed. Imagine being denied insurance because of a pre-existing condition that you didn’t know you had. To avoid this, insurance companies insist on a comprehensive health examination before they issue the health cover.
Maxed out
Every insurance policy defines the maximum amount that you’re entitled to annually. If you have a persistent health condition and you have to keep visiting the doctor, you may exhaust your disguise before the end of the year. In this case, unfortunately, you’re no longer entitled to any payouts.
Sometimes you have not touched your insurance for years, then comes a particular year when the hospital bills are at an all-time high because health can be that unpredictable. Can the insurance company increase your amount since you didn’t use any in previous years? Mostly not. An insurance cover is an annual contract, and once the year has elapsed, you cannot claim its benefits. Your only choice here is to pay from your pocket till the next year.
Maturity period
Health insurance covers take some time to be activated. Do not assume, for instance, that you can buy a policy today and it’ll cover your hospital next month. The exact waiting period differs from one policy to the other.
Remember, even after your policy is active, there are some conditions that are not covered. Make sure you understand and agree with these conditions before you put down your signature to avoid disappointment.
Conclusion
If you’re reading this after your claim has been declined, you now have an idea why you did not receive the expected payout. Better still, you could be reading this as you prepare to take up a life insurance policy. This will help you be aware of the mistakes to avoid in the process. However enticing a policy is, it is only tested in the hour of need. Keep these factors in mind so your health policy can come through for you when you need it.
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