Consumers Struggle with Health Insurance Claims Rejection and Policy Cancellations

Consumers in India are facing a major challenge when it comes to getting their health insurance claims processed, with many experiencing rejection and policy cancellations by insurance companies. A recent survey conducted by LocalCircles revealed that 43% of general insurance policyholders in India struggle the most with their health insurance claims, followed by motor insurance and home insurance.

In response to the difficulties faced by consumers, 93% of respondents expressed support for the insurance regulator IRDAI to make it mandatory for insurance companies to disclose details of claims received, rejected, policies approved, and policies cancelled on their websites each month. The survey, which received over 39,000 responses from citizens across 302 districts in India, highlighted the challenges faced by policyholders in getting their health insurance claims processed.

Policyholders shared their experiences of insurance companies rejecting claims by classifying health conditions as pre-existing, only approving partial amounts, and cancelling policies during the claims process. Many cited the time-consuming process of claiming health insurance, with some spending hours trying to get their claims processed, even after the patient is ready for discharge.

The Department of Consumer Affairs has raised concerns about mis-selling of insurance policies and has called for rules to be changed to ensure that insurance agents maintain audio-visual records of their sales pitches. This is to ensure that prospective buyers are fully informed about policy features and not just the positive aspects.

Despite interventions by IRDAI, consumers continue to face challenges with insurance companies when it comes to getting their health claims processed. The survey highlights the need for greater transparency and accountability in the insurance industry to protect the interests of policyholders.