• 28
  Sep
  2009

• Filing health insurance claims - Part 6

  Filed Under: Health Insurance

This is a continuation from previous posts where we talked about the health insurance claims process, some jargon was clarified and a few basic concepts were cleared. Let us look at some not so smooth sailing. We mean specifically a situation when the insurance company replies with a denied claim. Though it is not that common, it does happen once in a while. Here are a few ways to avoid such a scenario.

1. Be completely truthful when applying for a health insurance policy. Not declaring pre-existing conditions is a major reason for denied claims.


2. Be fully aware of each and every clause of the policy. That means you will have to read the fine print (as boring as it might seem) and in case you have some doubt, get it clarified. The insurer is legally bound to explain everything clearly to you.


3. Whenever you go to the doctor for something that seems even a little out of the ordinary, it is best to call the help desk and clarify if the event will be covered.

In spite of taking these precautions, if you do end up getting a denial, it doesn't mean nothing more can be done. You can definitely appeal, furnish more documentary evidence and seek a review. We will see how it can be done in a subsequent article.
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