A health insurance policy is meant to protect you - but one small mistake during the claim process can lead to delays or outright rejection.
Whether it’s missing documents, late intimation, or incorrect hospital details, most rejections happen due to avoidable errors.
At PolicyBachat, we’ve helped thousands of customers in Hyderabad, Telangana file and settle claims successfully through our Claim Assist Service - often rescuing claims that were initially rejected.
Here are the 10 most common claim mistakes and how you can avoid them to ensure your health insurance payout is smooth, fast, and stress-free.
10 Common Health Insurance Claim Mistakes
1. Not Informing Insurer on Time
Every insurer requires claim intimation within 24 hours (emergency) or 48–72 hours (planned).
- Always call or email your insurer/TPA immediately after admission.
2. Submitting Incomplete Documents
Missing or unsigned bills, reports, or discharge summaries are top rejection causes.
- Use PolicyBachat’s document checklist before submission.
3. Filing Claim for Excluded Illnesses
Cosmetic, dental, infertility, or pre-existing diseases (within waiting period) aren’t covered.
- Read “Exclusions” section of your policy carefully.
4. Wrong Policy Details or Member Name
Even a small mismatch between ID card and hospital records can delay processing.
- Verify name, DOB, and policy number before submitting claim form.
5. Late Submission of Reimbursement Claims
Most insurers allow
30 days post-discharge for reimbursement filing.
- File claims early to avoid administrative rejection.
6. Ignoring Network Hospital for Cashless Claims
Cashless facility applies only at listed hospitals.
- Use PolicyBachat’s Cashless Hospital Finder to verify before admission.
7. Non-Disclosure of Pre-Existing Illness
Hiding diabetes, hypertension, or other chronic conditions voids coverage.
- Always disclose full medical history - honesty ensures protection.
8. Claiming for Non-Medical Expenses
TV charges, food, or attendant costs aren’t reimbursed unless covered.
- Check your policy inclusions before submitting such bills.
9. Duplicate Claim Submission
Submitting same claim to multiple insurers without coordination causes rejection.
- Disclose other policies clearly; claim split is allowed under IRDAI norms.
10. Policy Lapsed at Time of Treatment
Claims during grace period or after expiry aren’t valid.
- Renew at least a week before expiry.
Local Insights For Hyderabad
- Top cause of claim rejections: Incomplete documentation
- % of claims rejected due to errors: 12%
- Avg. delay due to document issues: 7 days
- Insurers with best claim approval rate: ICICI Lombard, Bajaj Allianz
How To Avoid These Mistakes
- Inform insurer immediately after admission.
- Keep your documents organized and verified.
- Submit only genuine medical bills and reports.
- Renew policy on time and maintain coverage continuity.
- Use PolicyBachat Claim Assist for guided submission.
Policybachat Claim Assist Advantage
- Free claim filing and tracking support.
- Dedicated claim experts for every customer.
- Pre-verification of all documents before submission.
- 98% approval rate for properly filed claims.
- 40% faster settlements vs direct insurer process.
How Claim Assist Works
- Contact PolicyBachat via phone/chat/email.
- Share your hospitalization and policy details.
- We prepare and verify your documents.
- We submit claim on your behalf.
- Track progress until settlement confirmation.
Policybachat Tip
Most rejections are not because insurers don’t want to pay - they happen because customers miss small details. Claim Assist makes sure that never happens.
Tax Note
Rejected or delayed claims don’t affect your Section 80D tax deduction for premiums.
FAQs
What is the most common claim mistake?
Late intimation or incomplete documents.
Can rejected claims be reopened?
Yes - via insurer appeal or PolicyBachat Claim Assist.
Can I submit soft copies of bills?
Yes, if insurer accepts digital submission.
Is claim rejection final?
No, you can request re-evaluation within 30 days.
What if my insurer delays approval?
PolicyBachat escalates cases through our Claim Desk.
Does one mistake void my policy?
No, it affects only that specific claim.
Can I file claims for multiple hospitalizations?
Yes, within total sum insured.
Do I get partial payment if some bills are valid?
Yes, approved expenses are reimbursed.
Can I claim from two insurers?
Yes, proportionately as per IRDAI sharing rules.
What’s the safest way to file a claim?
Use Claim Assist - prechecked, documented, and verified submission.
Customer Reviews
- “My first claim was rejected - PolicyBachat helped reopen it.” - Ravi Menon, Kochi
- “Wish I read this before my claim delay!” - Sneha Reddy, Delhi
- “Document checklist saved my claim from rejection.” - Vikram Desai, Mumbai
- “Thanks to Claim Assist, everything went smoothly.” - Kavya Sharma, Hyderabad
- “Simple language, clear guidance - 5 stars.” - Rajesh Nair, Chennai
- “Best explainer on claim rejections I’ve seen.” - Ananya Iyer, Bengaluru
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