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Reasons for Rejecting Insurance Claims
Thursday, 07 January 2010 22:01
Rejected_ClaimMore than a few policyholders have been blindsided by insurance refusal to process their claims, and for more than reasons listed among the policies exclusions. Following your insurer’s claims procedure is the safest way to make sure your claim is not rejected and this includes, above all else, being honest. The following reasons were given by insurers for repudiating insurance claims.

Guilty claimant
The person claiming from the insurer is guilty of negligence, accident or deliberate damage. Your insurer will conduct an investigation after a claim has been made with them to determine fault, but also the extent of the damage.

Exclusions
Your claim may fall under one of the exclusions on your policy. For this reasons it’s important to know what these exclusions are and make sure that when your insurer updates your policy, you know what exclusions have been changed. These exclusions are in place to limit the risk of the insurance company which does reduce your premium. Best you act in compliance with their regulations.

Lying
If your insurer determines that for any reason you withheld or falsified information (which includes giving vague details), they can reject your claim. This could even lead to further prosecution and you could be penalised for insurance fraud.

Lost documents
Certain claims will require that you prove the value of items and that you in fact owned them. If you lose receipts for contents of your home, it may be difficult to prove that you lost them in some way.

Claim value
If the value of the claim is too high, as determined by your insurance company, they will either pay less or open an investigation of insurance fraud. Most insurance will only pay as much as market value on insured goods, but this depends on the policy.

In order to ensure that your claims are processed, find out what the claims procedure is from your insurer before lodging a claim.
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