Difficulties in Making a Claim Under a Cancer Insurance Plan

Choosing a health insurance company with a good incurred claim ratio is considered as a smart move. Although the procedure to file a cancer insurance claim is simple and quick, some claims might be rejected. Read more to know about the difficulties in making a claim under a cancer insurance policy and how to overcome the same.

• Cancer insurance policy is the need of an hour. People who are likely to get affected by this dreadful disease should buy one to get covered against cancer. But the rejection of cancer insurance policy can drop you into sheer despair. Sometimes, the insurance providers are at fault, while sometimes the insured is to blame.

• Technical development has provided advanced healthcare treatments for several illnesses. These treatments have increased the cost of healthcare. As a result, you may not be able to afford the quality treatment due to lack of funds.

• Cancer insurance policy is designed to provide financial protection against cancer treatment. It offers coverage in case you are ever diagnosed with cancer. Generally, a cancer insurance policy provides a lump sum payment which can help cover several costs related to cancer diagnosis and treatment, including hospitalisation, chemotherapy, radiation, and surgery, among others.

Q. When can cancer insurance claims be rejected?

• Many policyholders are dissatisfied with the services of insurance companies. The primary reason for their dissatisfaction is the difficulties in making a claim and rejection of insurance claim. Majority of these policyholders least care to know the reason behind the rejection but instead get easily frustrated for not being offered the required coverage. Research shows that some of these claims get rejected primarily because of the wrong choice made by policyholders at the time of buying insurance plan and secondly, incorrect information provided at the time making a claim.

• Policyholders need to understand their cancer insurance policy before buying to avoid these difficulties. One crucial point that every policyholder should keep in mind is the waiting period. This is the period before which there is no coverage offered for the disease. If an insured person claims for the same illness before the end of the waiting period, he/she would not be offered the policy benefits. Another point one should consider is to go through the exclusion section.

• Moreover, there is much confusion regarding the cashless hospitalisation facility. Policyholders should remember that cashless facility can be availed only in network hospitals and hence going to non-network hospitals to avail treatment on cashless basis does not meet the terms of the policy. The common reason behind these difficulties in making a claim under a cancer insurance policy is that policyholders do not read the terms and conditions of their cancer insurance policy and regular health plans carefully and thus, face difficulties at the time of claim settlement.

• It is therefore recommended that people choose the cancer insurance policy carefully, after considering their healthcare needs. You should also go through the terms and conditions and understand the policy so that they do not feel guilty over their choice later. All these difficulties can be avoided to some extent if a policyholder buys a comprehensive cancer insurance policy from a reputed insurer that cares for the needs of people while designing the policy. These companies try their best to offer the required coverage to the policyholders. Their products are coupled with the best facilities and services such that their customers are able to enjoy their lives to the fullest.

Q. How to make sure your insurance claim is not rejected?

Before you make a claim under your cancer insurance policy, it is better to ask yourself a few questions:

• Was there any information or pre-existing condition which you failed to disclose because it seemed unimportant to you?

• Was the claim made for disease not covered in your plan?

• Was it a claim for any self-inflicted condition? For example, a suicide attempt, skin cancer (if excluded)

• Were you able to present the required documents? This could be important paperwork which you might have considered unimportant when filing the claim.

• Did you inform the insurance company within the specified date or much later after hospitalisation?

• Did you make the insurance claim during the waiting period?

If your answer to any of these questions is affirmative, then you may face difficulties in making a claim against your cancer insurance plan. Thus, to avoid such difficulties and rejection of insurance claim, one should carefully read the policy documents.

Q. How to make sure your insurance claim is not rejected?

Policyholders are supposed to know all the terms and conditions of the insurance policy and also why claims are rejected, in order to avoid the inconvenience. Given below are some important steps that ensure a smooth claim settlement process for the policyholder.

• Complete disclosure: Even the minor detail about the existing ailment must be disclosed to your insurance company. It may increase your health insurance premium, but you will be ensured that your insurance claim will be honoured.

• Follow the claim procedure: It is important to be familiar with the steps to be followed in case you need to make a valid claim in the future.

• Renew your policy every year: Not immediately after purchasing a policy, but someday you would require to make a claim. For example, when a disaster strikes, you might need a valid plan to bear the medical expenses. You should, therefore, renew your policy every year on time to ensure continued coverage.

So, now you know what difficulties you may face while making a claim under a cancer insurance policy and how to avoid it. You can make the best use of your health plan by getting a thorough understanding of the claim settlement process and requirement stated in the plan. Make sure you don’t miss out on any document. In case you have understood the reason for the claim rejection and are ready with the supporting documents to prove the validity of your insurance claim in order to file an appeal.

Hence, a few precautionary measures mentioned here can save you from trouble and stress of rejection of insurance claims. All you need to do is stay informed and keep informing.

Recommended Link: How Does a Cancer Insurance Plan Work? Read Benefits and Coverage.