Home Lifestyle Why Do Insurance Claims Get Rejected: Check Out the Five Most Common Reasons – N.F Times

Why Do Insurance Claims Get Rejected: Check Out the Five Most Common Reasons – N.F Times

Why Do Insurance Claims Get Rejected: Check Out the Five Most Common Reasons – N.F Times


Worrying about one’s family’s financial stability is a constant concern, especially when the members depend on them. In this regard, a term insurance plan can prove to be a huge lifesaver. To elaborate, in case of the sudden demise of the insured, the insurance company provides a substantial financial amount to the policyholder’s loved ones, the policy beneficiary in particular. This lump sum allows the beneficiary to navigate daily expenses and face other obligations with much ease without being subject to hardships. However, what most individuals tend to forget is that it is not guaranteed that the claim will be approved every time. Many certain situations can lead to a life cover insurance claim rejection by the insurer. These situations mostly arise due to policyholders’ inability to understand policy clauses or exclusions and can prove detrimental to their financial future. That said, let’s check the common reasons that lead to the rejection of insurance claims and find a way around it.

What is Term Life Cover Insurance?

Term life insurance is a plan that extends financial support to your loved ones in the absence of the insured. During the specified insurance term, the policy ensures a substantial payout, or the death benefit, that goes directly to the designated nominee or beneficiaries. Notably, the benefit is a more complex hand-out. This is because the insurance company follows multiple steps before approving the claim. For instance, the insurance company diligently reviews the life cover policy details, then verifies the legitimacy of the policy nominee, and subsequently examines the claimed circumstances surrounding the insured’s death. Only if every detail passes the scrutiny of the insurer, the promised benefit would be released and made available to the nominee. Typically, there are certain situations where an insurance claim might get denied, this is why it is imperative that policyholders and if possible the nominees find out about them in detail before getting a policy.

Reasons Why Insurance Claims Can Get Rejected?

These are the top reasons why your claim is likely to get rejected –

1. Providing incorrect information

Even a simple mistake while filling out the insurance claim form can lead to big and unwarranted consequences. This is because every information matters when processing a claim, from the policy buyer’s age and income to their qualifications, including job, lifestyle choices like smoking and drinking, existing health conditions, and previous life insurance policies. This is why it is important to double-check all the details to ensure they are accurate. Typically, these serve as key factors that help determine the insurance premium, and missing any detail or providing wrong information can be assumed as fraud, potentially voiding the life coverage altogether.

2. Not disclosing medical history

Full disclosure is vital to secure an accurate insurance coverage. This is why policyholders must disclose their pre-existing medical conditions, past and upcoming surgeries, and existing health concerns that could potentially impact their insurance premiums. Additionally, lifestyle choices, such as smoking, drinking alcohol, and using tobacco, also affect the equation. Hence, it is always advised to be transparent about one’s habits. Similarly, it is suggested not to neglect one’s family health history as well. Individuals must share details about existing health conditions like cardiovascular disorders, blood pressure complications, cancer, or hereditary conditions. Offering a complete picture of health and monetary condition helps avoid claim rejections, ensuring the financial safety of loved ones in the future.

3. Not updating beneficiary details

Failing to designate a policy nominee or beneficiary for the life-cover insurance plan can prompt complications when applying for a claim. Usually, without a nominated beneficiary, the insurance payout process turns out to be uncertain and can potentially be subjected to delays and legal proceedings. Only by updating the beneficiary details on time, individuals can ensure a smooth and hassle-free claim settlement, extending much-required financial assistance to support designated family members. Additionally, one must carefully review the final copy of the application form and read the fine print carefully to understand the intricacies of the insurance benefits and what is life insurance limitations to make informed decisions about the plan and coverage.

4. Not disclosing existing plans

Disclosing details about all existing insurance policies under the buyer’s name is crucial during the insurance application process. Insurance providers typically factor in the existing insurance plans when they initiate the financial underwriting process, which helps determine the applicants’ premium and ensures the life cover adequacy. Notably, the failure to disclose existing insurance policies may hamper the underwriting process, leading to unwelcome consequences, such as insurance policy cancellation or ultimate claim rejection. This is why maintaining transparency and accuracy is important in securing appropriate coverage and ensuring financial security in the long run.

5. Inactive insurance policy

In order to claim one’s insurance policy is essential to maintain the play by paying the premium at scheduled intervals. Individuals’ inability to pay policy premiums would make it inactive, making the plan benefits unavailable to the insured.

Inactive plans are one of the common reasons for insurance claim rejection. Typically, most insurance companies offer a grace period when individuals must pay the premium after missing the scheduled premium date. Missing the grace period also leads to policy inactivity, making the policy benefits inaccessible to the insured and their beneficiary. This is why it is always advised to pick a policy plan with a premium that matches one’s financial standing and payment capacity.

Hence, individuals must make it a point to share all essential details with the policyholder, including health conditions, existing insurance details, income details, and lifestyle habits at the time of purchasing a policy. Similarly, they must name a nominee for their policy without delay and make sure to keep their policy active by paying premiums on time. This transparency and timeliness will help ensure the life cover claim does not get rejected during an emergency on the grounds of inaccuracy or inconsistency. In this way, individuals can ensure they or their family members have access to financial cover during an emergency.



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