You or your family faced a medical emergency. Bills piled up. And now your health insurance claim has been rejected.
It’s not just frustrating—it’s unfair. But don’t lose hope. Most health insurance claim rejections can be challenged and reversed with the right approach. This blog walks you through why claims are denied and how ClaimChase helps you fight back and win what’s rightfully yours.
❌ Common Reasons Why Health Insurance Claims Get Rejected
1. Incomplete or Incorrect Documentation
A missing hospital bill, doctor’s prescription, or diagnostic report can result in immediate rejection.
2. Policy Exclusion Clauses
Some treatments or diseases may be excluded in the first few years. Many people are unaware of these clauses.
3. Waiting Period Not Completed
Claims made within the waiting period for pre-existing conditions are often denied.
4. Hospital Not in Network
For cashless claims, this is a big reason for denial. Not all hospitals are covered.
5. Policy Lapse
If your premium payment was delayed or missed, your policy might have lapsed without your knowledge.
🧭 What To Do If Your Claim Is Rejected
✅ Step 1: Read the Rejection Letter Carefully
Understand the exact reason for denial. Insurers are obligated to give you a written explanation.
✅ Step 2: Review Your Policy Document
Compare the rejection reason with your policy’s terms. Many times, rejections are based on misinterpretation or vague clauses.
✅ Step 3: Gather All Necessary Proof
Collect additional medical reports, prescriptions, billing summaries, and expert opinions that can strengthen your case.
✅ Step 4: File an Appeal with the Insurance Company
This can be done online or through an offline grievance redressal mechanism.
✅ Step 5: Still Denied? Approach IRDAI or an Ombudsman
If the appeal is not resolved in 30 days, you can escalate it to the Insurance Ombudsman.
🤝 How ClaimChase Helps You Win Denied Claims
🛠️ Our Expert Services:
- Analyze your rejection letter and policy terms
- Build a strong appeal with all supporting documents
- Handle direct communication with the insurance company
- Reopen old or previously closed claims
- Provide legal and documentation support if the case escalates
💬 Real Story:
A client’s ₹2.3 lakh mediclaim was rejected due to a “pre-existing condition” not being declared. Our team found that the condition wasn’t pre-existing and got the claim approved in just 19 days.
🧾 Free Claim Audit by ClaimChase
Send us your rejection letter and we’ll review it for FREE. No hidden charges.
We’ve helped hundreds of families recover lakhs in medical claims—let us help you too.
📞 Need Help with a Denied Mediclaim?
📲 Call ClaimChase at +91 9373267717
🌐 Visit www.claimchase.in
📩 WhatsApp support available for fast documentation review
