Reasons why your Insurance Claims are Rejected

The difficulty of dealing with insurance claims is often a scourge for insurance policyholders. Not a few also make it as one of the reluctance to buy an insurance policy whether it’s health insurance, car, or travel insurance. But the difficulty of dealing with such claims is not without reason. Everything is in an agreement between the insurer and the buyer of the insurance policy and is bound by law. That is, claims will not be arbitrarily rejected. And here will discuss several reasons why insurance claims can be rejected.

Reasons why your Insurance Claims are Rejected


The policy is inactive

The insurance policy may be inactive due to some circumstances. This inactive state is also called lapse. The insurer is not willing to pay insurance claims when the policy is the lapse. Here are two examples of the circumstances of the policy being lapsed and making your insurance claim rejected.


  • Payment of insurance premium is due

If the insurance premium payment is due because it has passed the grace period. Every insurance may have different grace periods. Usually a maximum of about 45 days. If an event occurs after that period, the insurer shall not be liable for any loss suffered by the policyholder, even if included in the policy clause. Pay insurance premiums on time or at least not until the end of the grace period.

  • Policy insurance unit link shaped

If the insurance policy in the form of a unit link, the policy can be considered lapse if the cash value of insurance does not cover the cost of insurance. There are at least two causes of an inadequate value of this cash, which is not good investment performance and the cash value is often disbursed. To avoid it, it’s good to do a top up at a certain time when the investment performance is bad. In addition, make sure not to withdraw cash value, unless at any time in a state of urgency.


Claim Exceeded Set Time Limit

Insurance claims may be delayed or even rejected if the claim management exceeds the time specified in the policy. Insurance always gives a certain time limit for claim management. If the time has passed, the claim may be rejected. Car insurance claims should be taken care of immediately because the time limit is short, only 3 x 24 hours. As for insurance such as life insurance, the time limit between 30-60 days.


You were in waiting period

In certain types of insurance, there is a policy called the waiting period. The purchaser of the insurance policy will not be able to file a claim when it is in the waiting period. If the pain is severe, there will usually be a waiting period of 30 to 365 days.


Territories Excluding Insurance Services

Claims will only be served if occur in certain areas only. If a person insured his life in the United States and the policy states that a claim can only be filed if he dies in America, the claim will be rejected if he goes to England or other areas and dies there.


Lying to insurance company

An insurance policy owner may commit a lie or sabotage by injuring himself, burning his own home, or deliberately causing an accident to obtain compensation from insurance. The insurer will automatically reject the claim if upon investigation it is known that the action is intentional. The same is true when heirs commit crimes against the policyholder to get a claim from the insurer.


Claims are included in exceptions

The exceptions are things that are not covered by insurance coverage. In life insurance, these exceptions are in death due to suicide, court punishment, or crime. If in car insurance, the exceptions that make the claim rejected include vehicles that are not functioned according to the designation or modified without notifying the insurer. Examples of vehicles that are not functioned according to its designation are to use a motorcycle to transport goods that exceed the capacity. As for the case of motor vehicle modifications, be sure to always notify the insurance and make sure modifications are allowed. Do not make non-standard modifications that actually cause the accident. If this happens, the insurance will not want to bear the cost of repairs.

There are many reasons for rejecting your insurance claims and one of the best ways to find out is by carefully observing and understanding the contents of the policy. Many policyholders ignore it and ultimately lose money on their own.

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