Insurance claims can be a lifesaver in times of need, providing financial support when unexpected events occur. However, it can be frustrating when your claim is rejected for trivial or even silly reasons.
But that doesn’t have to be a problem because experienced legal professionals, like the skilled lawyers at Bentley & More, LLP, can assist you when you encounter such a problem. With multiple awards in their kitty, including Best Lawyers, Lawyer of the Year, and Top Plaintiff Lawyers, Bentley & More will ensure your case gets the best possible outcome. The firm also offers a free initial consultation so that victims can better understand whether they have a valid case.
Here are five reasons why an insurance company might reject your claim.
1. Failure to Disclose Minor Details
Insurance applications typically require detailed health, lifestyle, or property information. While it may seem harmless to leave out little facts, like a minor home remodeling or a previous medical visit for a routine cold, doing so can give insurers a reason to deny your claim.
Any differences, no matter how small, have the potential to prevent your claim from being approved by an insurance company because they depend on precise data to evaluate risk and determine rates.
According to the KFF Survey of Consumer Experiences with Health Insurance, 18% of people with health insurance reported having had a claim declined in the previous year.
2. Missed Deadlines
Even though it can seem like a trivial mistake, submitting your claim papers beyond the deadline can lead to rejection. There are rigorous deadlines for making claims under insurance plans following an occurrence.
If you miss these deadlines, the insurer may argue that they cannot properly investigate the claim or that it is no longer valid under the terms of the policy. To avoid this, you must familiarize yourself with the specific deadlines outlined in your insurance policy and act promptly after an incident.
3. Policy Exclusions
Insurance policies often exclude specific situations or events for which coverage is not provided. These exclusions can sometimes be surprising or seemingly arbitrary.
For example, your homeowner's insurance might exclude coverage for certain breeds of dogs, or your travel insurance might exclude coverage for injuries sustained during certain activities, like bungee jumping.
Reviewing your policy to understand what is and isn't covered is essential to avoid a claim denial based on an exclusion.
4. Incorrect Documentation
When filing a claim, providing accurate and complete documentation is crucial. Even minor errors in paperwork or missing documents can give insurers a reason to reject your claim.
For instance, in the case of a car accident claim, failing to provide a police report after an accident or not including all medical bills and receipts related to a health insurance claim can lead to denial. Double-checking your paperwork and ensuring you have all the necessary documents can help prevent this from happening.
5. Pre-existing Conditions
Pre-existing conditions are a common source of dispute in health insurance. When you request compensation, the insurer might deny your claim if you don't disclose a pre-existing condition.
Even if the condition seems unrelated to your claim, insurers may scrutinize your medical history to find reasons to deny coverage. It's essential to be transparent about your health history when applying for insurance to avoid potential claim rejections in the future.
Final Thoughts
Even though insurance is meant to offer financial security, claims might be denied for petty or unjustified reasons. To avoid these situations, it's crucial to understand your insurance policy thoroughly, provide accurate information when applying for coverage, and follow the correct procedures when filing a claim.
By being diligent and proactive, you can increase your chances of successfully processing your claim and receiving the support you need when unexpected events occur.
