What To Do If Health Insurance Claim Is Denied In India

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What To Do If Health Insurance Claim Is Denied In India. If your insurer notifies you that it has denied a claim, you should receive an explanation of benefits document that spells out why the claim was denied. For smooth claim settlement, the health insurance company would require original hospital bills, medical practitioner’s certificates, hospital discharge summary, etc.

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Do your own research and check the paperwork to see if everything is in place (insurance premium receipts, any break or lapse in the policy, any dispute in the past). You may need to file an appeal through a health insurance claim denial appeal letter. You must provide all required documents as many times as necessary until a resolution is achieved.

Reasons For Health Insurance Claim Denial 1.


Thoroughly check your policy documents to see if the claim denial is legitimate. What to do if the claim is denied. Examine the copies of documents submitted by you in support of your claim, check your policy and ensure that your claim is denied legitimately, if not contact your insurance broker or insurance company’s branch office from where you have taken the policy, talk to them, clear your doubts and complain about your grievances and ask for a review of the case.

If Not, There Is A High Probability That Your Health Insurance Claim Gets Denied.


Do your own research and check the paperwork to see if everything is in place (insurance premium receipts, any break or lapse in the policy, any dispute in the past). If your claim filing is improper or incorrect, your claim stands to be denied. Informing the insurer of the emergency, seeking treatment in a recognized hospital, filling up the required claim form, attaching all the relevant bills and reports are some of the required things to do for making a claim.

Have Handy All The Questions You Have About Your Claim’s Denial As Well As The Details Of Your Treatment.


If your health insurance claim was denied, aizenman law group can assist you in filing an appeal or a lawsuit in order to ensure you get your medical expenses covered. Submission of all the relevant medical bills. You should find contact information on the back of your insurance card and the denial notice.

Much Like You Would For Other Types Of Claims, You Will Review Your Policy, Gather Evidence To Support Your Claim, Write A Letter And Appeal The Decision.


You must provide all required documents as many times as necessary until a resolution is achieved. Please follow the below mentioned steps according to the mistake you have made: Check your name and the policy number.

Get A Written Claim Denial Letter From Your Insurance Company Stating Why Your Claim Was Rejected.


What’s more, most people with denied claims didn’t appeal their insurer’s decision, and when they did, they typically got denied again. Thoroughly check your medical insurance claim form, which you have submitted to your health insurance company. In this article, we provide you with a guide on why your health insurance claims got rejected and what to do if your health insurance claim is denied.

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