Group Health Insurance

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What are the reasons for claim rejection in GPA?

You can claim in a GPA policy against accidental death, permanent or temporary disability. You can also claim against partial disability and accidental medical expenses. These claims will depend on the coverage in your policy. However, there are chances that your accidental claim, though legitimate, is rejected by the insurer. Below is the list of policy exclusions due to which your claim is likely to get rejected. The list of exclusions varies from insurer to insurer. You need to refer to your policy document for a complete list of exclusions.

1. Any pre-existing illness or injury.
2. Self-inflicted injury/ Suicide attempt.
3. Accidents due to alcohol or drug abuse.
4. Participation in dangerous sports.
5. Injuries as a result of criminal or disorderly behavior.
6. War or civil unrest.
7. Person on duty with military, police, or paramilitary organizations until clearly specified in the policy.
8. Snake-bite and Animal-bite until clearly specified in the policy.