Demystifying cashless claim rejections: Uncovering the key reasons and solutions

Cashless rejection happens more frequently than most people perceive. One in fourteen cashless claims is rejected. While there are many reasons for a cashless claim to be rejected, we have listed some common reasons for rejection.

Reasons For Cashless Rejection

  • Non-disclosure of pre-existing diseases or health issues at the time of buying a policy.
  • Treatment for the disease is in the waiting period. For example, if there is a waiting period of 2 years for kidney stones and you claim after one year of buying a policy, you will not get the claim.
  • Sum Insured is exhausted and no balance is available.
  • The Hospital is not covered in the cashless network or preferred partner network (PPN) of an insurer.
  • The insurance company needs more information regarding the medical history of a patient, so they advise applicants to apply for reimbursement claims and submit those documents.

If you are dissatisfied with the reason provided by the insurer for cashless claim rejection, you can always go for a reimbursement claim for your treatment.

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