When it comes to health insurance, Star Health and Care Health Insurance are two of the leading companies in India. However, they have been recently under fire for their high percentage of claims rejected. In the financial year 2022, Star Health had a claim rejection rate of 17.2%, while Care Health had a rejection rate of 13%. This means that for every 100 claims made, these two companies rejected 17 and 13 claims respectively.
There are a number of reasons why claims are rejected by insurance companies. Some of the most common reasons include:
- Policy Adherence: Claims falling outside the policy’s terms and conditions can face rejection.
- Documentary Support: Claims lacking adequate documentation may be declined.
- Fraudulent Claims: False or misrepresented claims can lead to rejection.
- Timeliness: Late submission of claims can be a reason for denial.
In some cases, policyholders often also face challenges in getting their claims processed even if they meet all the requirements. This is because the claim settlement process can be complex and time-consuming. Policyholders will have to submit a lot of paperwork and documentation, and they may also have to go through multiple levels of review before their claim is finally approved.
How to Avoid Claim Rejection?
The high claim rejection rates of Star Health and Care Health Insurance are a cause for concern for policyholders. If you have a health insurance policy, it is important to be aware of the challenges you may face if you need to make a claim. Here are some things you can do for making a successful claim with a health Insurance company:
- Policy Understanding: A clear understanding of your coverage can help you navigate the claim process more effectively.
- Organize your documents: Keep all relevant documentation, such as medical bills and reports.
- Prompt Claim Submission: Ensure you initiate the claim process promptly after receiving medical treatment to avoid any unnecessary delays.
- Get Help: If you run into any challenges while making a claim, don’t hesitate to contact the insurance company’s customer service. They’re there to offer assistance and advice to help resolve your issues.
- Insurance Ombudsman: If you’re still facing difficulties, you can approach the insurance ombudsman. This independent authority acts as a mediator to help settle disagreements between policyholders and insurers, ensuring a just and impartial outcome.
Not Happy with Your Health Insurance Policy? Here’s What You Can Do
You purchase health insurance with the thought that it will offer you financial protection and save you from burning huge holes in your pocket if you undergo hospitalisation in the future. However, there might be a possibility that you’re not happy or satisfied with the policy you’re currently covered under or with the insurer with whom you currently have a policy. Or there might be features or benefits you want to opt for, but they are not available under your existing policy.
If you’re not satisfied with your health insurance policy, we can help you port your policy to a new company with a better claim settlement ratio. Feel free to reach out to us to explore this option further.
