5 Reasons Why Your Insurer Might Refuse Your Claims

Whenever you make a claim on your insurance policy, you may be shocked to realize that insurers won’t pay or are ready to pay only a fraction. As a policyholder, it is pertinent to be in the know as to why this might happen. 

Claims refusal may affect the relationship between you and your insurer. But it happens and you have to be prepared.

However, it is necessary to note that these claims can only be made within the listed rules in the insurer’s policy. So going straight to the purpose of this piece, we will be talking about some reasons why your insurer might refuse your claims;

1. Claims Made Not Included In The Policy

It is essential to conduct thorough research or consult expert insurance advisors before buying into any policy. Knowing fully well that each policy are guided by terms and conditions in fine prints. 

For every policy, there are peculiarities to the coverage it provides across different insurers.

In a nutshell, understand the coverage of your policies.  Else, you’ll be disappointed at the point of making claims.

2. Missing Information from your Application 

There should be no compromise for full disclosure in your policy documents. It is advisable to be sincere, honest, and thorough when filling any insurance applications.

Let’s say in medical related insurance, provide the insurer with your full medical history when purchasing a policy. There are also instances when a doctor documents a medical condition but it not disclosed to the patient.

Unfortunately, this kind of activity can also lead to a claim rejection, even if the patient isn’t aware of it, so if you’re not too sure, you should ask the doctor for a copy of your medical records.

3. When You Contribute to the Cause of the Accident

This is often one of the significant causes of claim rejection in housing or movables, like auto insurance, when the client is not careful or negligent in behavior. This could come in form of drunk driving, disobedience to traffic laws or dangerous stunts.

When this is established, you may have your claimed denied by the insurer.

Additionally, even if you have a driver taking you around with your approval, and it happens that he’s drunk driving, you will be held responsible for any damages that occur.

4. Due to Outdated/Incorrect Personal Details

There’s a high possibility that your insurer might refuse your claims if your details are not correct or when they are outdated, so you should ask yourself how often you update your details with the insurance policy.

It has been observed that in most cases, the details held by the insurance policy tend to get outdated, so you must check and update your details often. Especially when personal changes are made, such as bank details, addresses, jobs, or any relevant detail changes, they must be made known to the insurer to avoid refusal.

5. When Damaged is not Caused by Disaster

When damage is done by other causes, the insurance policy is not liable for any compensation or remuneration; it will only account for damages of events covered by the insurance policy.

You must provide evidence that the cause of the damage was natural, maybe due to a storm or any other disaster, and not damage that has been existing because if the insurers find out, it will lead to claim refusal.

Final Thought

To be in a safe place with your policies, carry along an expert insurance advisor right from the onset. We also advice that you review your policies at least once a year.

These two simple decisions will save you a lot of pain, legal fees and more in the future.