May 19, 2018

What should I do when my Life Insurance Claim gets Rejected?


Stay Alert - Series 19

If your life insurance claim is rejected, then you must first understand the reason of rejection. Before taking any further action, you need to go through your case and documents carefully. You must also review the terms and conditions governing the life insurance policy. If there is any discrepancy, you can take further action.

Suggested Read : Steps to handle Insurance claim rejection.

Detailed discussion with the insurer’s representative:

Before registering a complaint about your rejection, you can have a detailed discussion with the representative of your insurance company. You can let him know that your claim has been rejected. This will make the insurer to review your case in a detailed manner. In this way, your complaint can be resolved earlier.

Explanation for reasons of claim denial:

There may be certain oversight in your life insurance claim documentation. You should clarify the reasons and rectify the loopholes immediately. But if your claim is rejected for some other reason, then you can go for appealing your claim. You can certainly solicit for a detailed explanation about the same.

It’s always the time which matters a lot:

You must respond to the insurer’s communication within the timelines specified. You must not be lethargic. You should always respond to the queries raised by the insurer and within the timelines. This is because many of the insurance companies have specified timelines for claiming the life insurance amount. The time constraint is of significant concern for you.

Intercession:

You are not satisfied with your claim amount or your insurer has straightway declined your claim without a valid reason. You have an option to go for arbitration to settle the disputes.

Vigilant record-keeping:

You should always keep a record of the persons whom you talked to regarding your insurance claim rejection. Also specify the date, what was promised and what was decided during the conversation. You must do this for every personal meeting and even for phone calls. This will help you to approach later for litigation or arbitration.

Appeal procedure:

If you feel that your life insurance claim is rejected without a good reason, then you must acquire knowledge about the appeal process. You must check the instructions for filing an appeal against the insurer. Most importantly, take care of the time limitation period for appeal filing.

Check internal review:

In the meantime, you must review your documentation. Have a meeting with your doctor and confirm whether the doctor has provided the right information. If there is an error on the part of the doctor’s staff, then fix it immediately and resubmit the documents to the insurer’s office.

Time to file an appeal:
If the insurance company does not care about your request and still refuses to pay the claim, you have every right to file an appeal with your insurer, who will be called for an internal review to submit their decision and supporting documents on the case.

Seek the help of Insurance Ombudsman:
The Insurance Ombudsman offers independent and free service, investigating the complaint you raised against the financial institution. He / She will hear both sides of the story, cross check the documents and come to a fair conclusion. If they find right on your side then the insurance company will be called to explain their action, apologize and pay compensation.

Stay Alert, Stay Safe.

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