While availing any General insurance policy, the insured would never ever wish that his claim is rejected at any time. It can be really disheartening especially after paying premiums for a couple of years. However, to save yourself from such a shock it’s important to understand the provisions when claims can be rejected.
If you have been in the unfortunate position of seeing your claim rejected by the general insurance company, you need to ask yourself the following questions before you decide to go eye-to-eye with the insurer:
1. Has the policy expired or the premium cheque dishonoured?
This can be one of the primary reasons for the claim not being paid by the insurer. If you have paid the premium on time but the cheque was dishonoured by the bank because of some reason, the insurer is bound to reject the claim. Moreover, sometimes, the renewal of policy needs to be done with the detailed procedure. If you have missed renewing your policy which has now expired, there is no question of allowing a claim under a cover that no longer exists in your name!
2. Does the date of the claim fall outside policy period?
Your policy might not cover claims which do not fall in the policy period. For example, in a critical illness insurance policy, if cancer is to become valid after one year of taking the policy, but you make a claim for it within this period, it will not be welcomed by the insurer, however much you may need it. Therefore, it is suggested to read the fine prints before availing it so that there is no problem while making a claim.
3. Is something illegal involved?
You might have been an ardent follower of law, but it might be someone else at fault which you cannot deny. General Insurance companies will always assess the situations in cases of accidents before they accept your claim. For example, in the case of an accident, if you are named in the complaint, or it is found that your representative was involved in a prohibited activity at the time of the accident the claim may be rejected. An example of such error would be, lighting fire or smoking in a no-fire zone.
4. Has the ownership of the vehicle/property changed, but the Insurance Company has not been informed about the same?
Property can change hands. Once you have sold the property (or given up its possession in favour of the other) you lose the insurable interest in it; i.e. in case the property is damaged, only the owner has the interest in the wellbeing of the asset. Therefore, the insurer will reject the claim coming from either party, if the transaction has not been informed to the insurer within the specific time limit.
5. Does the claim include a known condition when policy started?
Any insurance has a commencement date for various risks covered, some may be covered from day one, others may be covered after a specified period. For example, a critical illness policy may not accept a claim for a heat failure within 90 days of commencement. Any claim made for the same on the insurer is sure to be rejected on these grounds.
6. Is the claim one of the exclusions of the policy?
Exclusions are not acceptable in any form! Suppose you own a shop and have a fire insurance policy which does not include the valuable paintings on the wall, you cannot make a claim just because in the case of damage due to fire, everything else is being covered. General insurance companies are very strict when it comes to exclusions, and such claims will not be allowed in any form by your insurer.
It is necessary to be aware of the provisions as well as the exclusions of all the policies that one avails. While it may be a tedious task to read and understand all the conditions, it can be easier if you collaborate with a knowledgeable and trusted advisor on the way.
SecureNow offers insurance advisory to corporate and individual clients through an online portal, which is quick, full of options and transparent. A 24×7 customer support and claim management services will certainly help you to improve your chances of settlement.
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