Fussing Over Medical Bills?

Insurance claims getting rejected? Find out what you can do to avoid it?

- Suyash Desai

It only requires one major hospital stint to break the backbone of a household’s finance. So, being insured is one of the basic necessities today along with food, clothing and shelter.

As per data from World Health Organisation, India has highest number of diabetic patients in the world. Individuals affected due to cardiovascular diseases are also on the rise. Besides, rapid urbanisation without planning, and an inclination towards adopting western ways of life is taking a toll on health of the citizen. This is compounded by the indifference and the lack of will of the successive governments towards the health sector. Though Modicare (Ayushman Bharat) is an exception, there are certain implementation issues with that as well. In such a situation, health insurance is definitely a way ahead for protecting oneself against the uncertainties.

But what if your health insurance claim gets rejected? What if the insurer points at the discrepancies as grounds for rejecting the claims, when you need money the most? According to Insurance Regulatory Development Authority (IRDA) Annual Report 2016–17, insurers have settled 82.1 per cent of total number of claims registered while they have repudiated 10.2 per cent of the claims. A country with the second highest population in the world, 10.2 per cent of the total claimants, is in fact a big number. And managing the same is not an easy task.

Let us assess the reasons behind claim rejections and way out in such a desperate situation.