What is Claim Rejection ?

A claim rejection occurs when an insurance company denies your request for compensation or benefits under your policy. This means the insurer has decided not to pay the claim amount you filed — either partially or entirely.
At Insurance Nidaan, we understand how stressful and unfair this can feel, especially when you’ve paid premiums on time and trusted the policy to protect you during tough times.

Common Reasons for Claim Rejection

  • Incomplete or incorrect documentation during claim submission.
  • Non-disclosure of facts (for example, pre-existing illnesses not mentioned).
  • Lapsed policy due to non-payment of premiums.
  • Policy exclusions that are not covered under the terms.
  • Delay in filing the claim beyond the permissible time period.
  • Misrepresentation or mismatch in details between forms and records.

FAQs on Claim Rejection – by Insurance Nidaan

What is a claim rejection in insurance?

A claim rejection occurs when an insurance company denies paying your claim amount, stating that it does not meet the policy’s terms and conditions. This means your request for coverage or settlement has not been accepted — either due to technical, procedural, or policy-related reasons.

Why do insurance companies reject claims?

Common reasons include:

  • Incomplete or incorrect claim documents.
  • Non-disclosure of pre-existing medical conditions or important facts.
  • Policy lapse due to non-payment of premium.
  • Claim filed after the allowed time limit.
  • The event or reason not being covered under the policy.
  • Mismatch or inconsistency in the information provided.
What should I do if my insurance claim gets rejected?

If your claim is rejected, don’t panic or give up.
 Reach out to Insurance Nidaan with your policy and rejection letter. Our experts will:

  • Review your policy clauses and insurer’s response.
  • Identify if the rejection is valid or unfair.

Guide you on the best way to appeal or reapply for claim approval.

Can a rejected claim be reopened or reconsidered?

Yes, in many cases a rejected claim can be reopened and approved after a proper review. If the rejection happened due to an oversight, missing documents, or misinterpretation, Insurance Nidaan can help you file a strong representation to the insurer or escalate it to the Insurance Ombudsman.

How long does it take to resolve a rejected claim?

The timeline varies based on the case complexity and the insurer’s response, but typically ranges between 15 to 60 working days. Our team keeps you informed at every stage of the process.

Is there a time limit to appeal a rejected claim?

Yes. In most cases, you can appeal within 30 days of receiving the rejection letter. However, depending on the situation, delayed appeals can still be considered. Insurance Nidaan helps ensure that your appeal is filed properly and within valid timeframes.

How can I prevent claim rejection in the future?

To avoid future claim rejections:

  • Always disclose accurate and complete information.
  • Read your policy terms carefully before buying.
  • Keep your documents updated and premium payments on time.
  • Inform your nominee about policy details.

 

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