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Common reasons for insurance claim rejection

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Buying a life insurance policy is the first step for anyone planning for a financially secure future. Claim rejections are not the norm – but there are two main reasons why a policy could be rejected so it’s important to understand how you can avoid these situations.

  1. Fraud: Refers to insurance fraudsters who take out a life insurance policy for someone who is terminally ill or, in some cases, impersonate persons who are already dead just so that they can avail of the life cover.
  2. Non-disclosures or false disclosures: When purchasing a term insurance plan, you should provide all material information regarding their income details, health status, medical history, and lifestyle in a truthful manner. If you withhold or give false information, it can become a valid reason for rejecting a claim.

You can safeguard yourself easily by following these steps.

  • Being transparent and revealing all the information in an honest manner to the insurer. If the information is true and correct to the best of an applicant’s knowledge, no claim can be denied or disapproved.
  • Making timely payments of the insurance premium.  If you fail to pay the premium on time, the policy is not active, and no claims can be entertained on an inactive policy.
  • Choose an insurer with a high claim settlement ratio.

My insurance claim was rejected – what should I do?

Most companies have multiple modes of access:

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  • The first thing that you should do is visit the company website and go to the customer service or claims section, as appropriate. There, the company lists all the ways to contact them, which typically include a WhatsApp number, an email address, a chatbot, a toll-free number to call, and in some cases, the location of the nearest branch. These services are available even if you purchase the policy through an agent.
  • If needed, you can reach out to a Grievance Redressal Officer (GRO) to register a complaint at a higher level. There is also a cell for the redressal of grievances at IRDAI, where you can register your complaints with the regulator under the “Bima Bharosa system”. You can register the complaint on a given email id, a toll-free number, or in physical form as well to the IRDAI address. This cell takes up customer grievances with the respective insurers for redressal.

The bottom line is that regardless of the type of insurance or amount of coverage you are opting for, you just need to be honest and transparent when filling out your application. Avoid non-disclosure or false disclosure of material information to have a tension-free experience.

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Satishwar Balakrishnan
Satishwar Balakrishnan
Satishwar Balakrishnan is MD & CEO, of Aegon Life Insurance. A chartered accountant by profession, he has worked with IndiaFirst Life, Reliance life and ICICI Prudential. He has a rich experience of close to two decades in the Insurance and Finance Industry. The views expressed are his own.


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