5 "Tips" to Avoid Rejection of Insurance Claims

 

One method to ensure protection against unforeseen circumstances that could result in financial losses is through insurance. For instance, accidents, schooling issues, and health issues. However, there are times when customers have trouble submitting their insurance claims because there is a misunderstanding between them and the insurance firms regarding financial services. Here are five suggestions provided by Tax.com from the Financial Services Authority to prevent insurance claims from being denied (OJK).

 

Know Your Insurance Coverage

Make sure the claim you're filing is actually covered by the insurance policy before submitting it. The OJK claims that failure to file an insurance claim is typically caused by an individual's ignorance of the details of their insurance coverage. Just so you know, only things or occurrences that are mentioned in the insurance policy or contract agreement are eligible for guarantees.

It is certain that the customer cannot file a claim if the events that occur are excluded or not listed in the policy benefits. For instance, with the exception of plastic surgery, a health insurance policy ensures the cost of surgery. In other words, insurance companies will not pay claims for the expenses of cosmetic surgery.

 

Must Be a Current Insurance Policy

In accordance with the terms of the insurance provider, the client must always pay a premium before they can file a claim. Because the insurance policy state is inactive if the customer has unpaid premiums, it goes without saying that the insurance claim will be denied.

 

Become Aware Of The Insurance Waiting Time

The insurance company typically establishes a waiting period before you can file a claim. Before claim payments can be made, a set amount of time must elapse during the waiting period. You must make sure that claims are submitted after the customer has passed the waiting time that the insurance provider has set.

 

Comply With The Insurance Claim Conditions

The customer's inability to comply with the insurance company's document requirements is another reason why an insurance claim is not submitted. Despite the fact that each of these administrative papers needs to be completed. If not, the insurance provider will deny the claim made by the beneficiary.

 

Don't Transgress The Good Faith Principle

In the realm of insurance, the fundamental tenet of "utmost good faith" serves as the cornerstone of the insurance contract. Don't attempt to go against the good intentions rule for that reason. Customers who disregard this rule risk serious consequences, including refusal to pay claims or the amount guaranteed as specified in the policy. Due to this, the customer who holds the insurance as the insured must provide as much information as possible about the insured item in order to avoid accusations of factual concealment.