Having Health Insurance for you and your family is always a great financial decision which you will take. But its frustrating when you claim your insurance and it gets rejected.
So here are few reasons why your insurance is rejected and how can you avoid that.
A Survey conducted by Policy Bazar, states that around 75% of Health Insurance claim are rejected, which highlights the need of policy holders to better understanding of Health Policy & its Terms and conditions.
According to Survey 25% of claims are rejected due to NON- DISCLOSURE of previous ailments and diseases.
When you are purchasing a health insurance, do inform your insurance company about your complete medical history or if you suffer from any the ailments such as diabetes, hypertension.
Basically when you go for any operation in any hospital, you need to inform the doctors about your complete history or you are sufferrifng from any ailments and diseases, accroding to which your treatment is plan & the same history is also mentioned in your health records such as Discharge Card, OT notes. Which you attach with your health insurance claim form.
So while purchasing the health insurance if you haven't mentioned about this ailments, there are high chances that your Health Insurance will be Rejected.
Another major chunk ie.25% Health Insurance are rejected due to Claim Outside the Coverage.
While purchasing health insurance make sure you read all the terms for cover. If your OPD (Out Patient Department) visits are covered in your health insurance or not. If they are not covered and you apply for the same, your claims are going to get rejected. So Its very Important to understand what your Health Insurance Policy Covers and what not.
Also over 16% of Health Insurance claims are rejected due to insurance holder does not revert back to the Query.
An insightful observation done in the survey was, that the sum insured plays a major role in claim rejections.
only 2% of claims were rejected who had sum insured between Rs.50 Lakh to Rs.1 Cr . whereas 53% of claims were rejected who had sum insured in the category of Rs. 5 Lakh.
Does Physiotherapy Treatment in covered in Health Insurance?
Weather physiotherapy treatment is covered in your health insurance or not it actually depends on your policy terms. If your policy covers OPD charges, than you can claim your Physiotherapy treatment charges.
If your policy covers Post Hospitalization treatment charges, then you can claim physiotherapy treatment charges.
Dr.Dhammick Shinde PT, MBA in Healthcare Management
He is the Founder & Managing Director of Cura Advanced Physiotherapy.