Delay in claims process Insurance companies are slow in processing claims. At GIGIS we value the importance of your time. We help you ensure that your claim is processed quickly, as we know that it can be a bad experience for a policyholder.
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In the context of insurance claims, delay refers to a situation where an insurer fails to process or settle a claim in a reasonable amount of time. For example, as per IRDA, a health claim should be processed within 30 from the final submission of documents. Sometimes an insurer does not respond to a client’s request for payment or investigate within a reasonable time frame. Such situations lead to further delays in claim settlement.
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The insurance company is required to furnish a valid justification for any delays in the claim process. Should such clarification be lacking, GIGIS stands ready to assist you in addressing the matter with the insurer.
1. Lack of Proper Documentation: One of the most common reasons for denied or delayed claims is a lack of proper documentation. This includes things like medical records, police reports, and other documentation that is required to support your claim. Make sure you have all the necessary documentation before you file your claim.
2. Policy Exclusions: Your insurance policy may have certain exclusions that prevent you from being covered for certain types of losses. These exclusions can vary depending on the type of insurance you have, so it’s important to understand what your policy covers and what it doesn’t.
3. Pre-existing Conditions you have a pre-existing condition that is related to your claim, your insurance company may deny or delay your claim. This is because they may argue that the condition existed prior to the incident that caused the loss.
4. Failure to Report the Loss in a Timely Manner: Many insurance policies require you to report a loss within a certain time frame. If you fail to do so, your claim may be denied or delayed.
5. Fraud: Insurance companies are on the lookout for fraudulent claims, and if they suspect that your claim is fraudulent, they may deny or delay it.
6. Dispute over the Value of the Loss: This can happen when the insurance company and the policyholder disagree on the value of the damages or losses.
A delay in claim processing indicates that the insurance company is still in the process of evaluating the claim, whereas claim rejection signifies that the insurance company has declined the claim. Nevertheless, in the event of claim rejection, there remains an option to challenge it.
