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Almost 43 pc health insurance policyholders struggled to get claims processed in last 3 yrs: Survey – ET HealthWorld

Mumbai: About 43 percent health insurance policyholder have experienced difficulties in achieving claims processed In the last three years, a survey Has been found. The survey, which included more than 39,000 respondents from 302 districts of the country, revealed that Challenges This includes rejection of claims, partial approval and the long time it takes to process them.

Majority of 93 percent respondents in the survey localcircle advocated change in regulatory frontincluding ordering Insurance company Disclosing detailed claims and policy cancellation data on its websites each month.

“Despite some interventions by the Insurance Regulatory and Development Authority of India (IRDAI), consumers continue to struggle with insurance companies to receive their health claims,” ​​LocalCircles said in a statement.

It pointed to denial of health insurance claims, including “policy cancellation” by insurance companies, as the top problems faced by consumers.

Challenges faced range from insurance companies rejecting claims by classifying a health condition as a pre-existing condition to only approving a partial amount.

“In many cases cited by policy holders, it took 10-12 hours after the patient was ready for discharge to actually be discharged as the health insurance claim was still being processed,” it said.

The survey said that 39 per cent of those who buy or renew general insurance policies do so through agents, 40 per cent rely on online aggregators and 14 per cent through insurance companies’ websites or apps.

  • Published on May 3, 2024 at 06:29 am IST

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