Why denial?

47. Why does health insurance have a denial?

The claim rate of insurance companies is more than 98%, why is there a denial of claims?

There are mainly the following:

(1) The type of insurance is not correct, and the accident insurance is bought, and the claim is not settled because of the hospitalization due to illness

(2) Not within the insurance period. For example, there are three types of accident insurance, which have three effective times: 00:00 on the next day/ after 3 days/designated time, and no claim will be claimed during the insurance period.

(3) Insurance during the waiting period. The waiting period varies from 30 days to 90 days to 180 days. If the insurance is issued during the waiting period, no claim will be settled, and the premium may be refunded and the contract terminated. Suspected of taking out illness insurance.

(4) Failure to fulfill the obligation of truthful notification. Health notices must be completed to purchase insurance, and if there is deception/concealment, it will inevitably affect future claims. In particular, matters that have not been informed are directly related to the occurrence of insurance.

(5) The policy has lapsed. If the fee is not renewed for various reasons, the insurance company will give a grace period of 60 days. Renewal should be made within 60 days. After 60 days, the policy is temporarily invalidated without renewal.

(6) Disclaimer of Warranties. Buy insurance to know what to protect and what not to insure. Congenital/pre-existing diseases are not compensated, rehabilitation costs are not compensated, dental cosmetology is not compensated, drunk driving is not compensated without a license, and million medical treatment is not compensated under 10,000.