The Story
Introduction
Health insurance is growing fast in India. More and more people are buying policies to protect themselves during medical emergencies. These plans are supposed to give peace of mind, but many policyholders face unexpected problems when it’s time to claim. Complicated terms, delays, small settlements, or even claim rejections are common issues.
Common Problems in Claim Processing
Imagine being admitted to the hospital for emergency surgery, thinking your health insurance will cover it — but instead, you’re told your claim won’t be fully paid. That’s what happened to many people. One big reason is that insurance companies often say a health problem was “pre-existing” and not declared when the policy was bought. This leads to a reduced claim amount or a complete rejection. That’s why knowing the right claim process is very important.
Real Story: Mrs. Mehra’s Claim Struggle
Mrs. Mehra, a 58-year-old retired woman, had severe stomach pain and needed urgent surgery. She had health insurance and thought the costs would be covered. But after the treatment, when she submitted a ₹3,00,000 claim, the insurance company rejected it.
The reason? She hadn’t mentioned a small, unrelated health condition when buying the policy. She didn’t think it was important, but the insurer used it as a reason to deny her claim. Mrs. Mehra was left feeling helpless and worried about the big hospital bill.
After follow-ups and expert help, the insurer accepted the mistake and cleared ₹2,50,000 of her claim. Mrs. Mehra got financial relief and realized the power of professional support.
Conclusion
Mrs. Mehra’s experience shows how difficult health insurance claims can be. It also shows the importance of expert help. If you or someone you know is facing similar issues, don’t lose hope. — we’re here to help you get what’s rightfully yours.
