MumbaiA: lmost 43 per cent medical insurance policyholders have skilled difficulties in getting their claims processed within the final three years, a survey has discovered. The survey involving greater than 39,000 respondents hailing from 302 districts within the nation identified that the challenges embody rejection of claims, partial approvals, and the very long time taken to course of them.
A majority of 93 per cent of respondents within the survey by Localcircles advocated for modifications on the regulatory entrance, together with mandating insurance coverage firms to reveal detailed claims and coverage cancellation knowledge on their web sites every month.
“Regardless of some interventions by the Insurance coverage Regulatory and Growth Authority of India (Irdai) customers proceed to grapple with insurance coverage firms to get their well being claims,” Localcircles stated in a press release.
It pointed to rejection of medical insurance claims, together with “cancellation of insurance policies” by insurance coverage firms as the highest points confronted by customers.
Challenges confronted ranged from insurance coverage firms rejecting claims by classifying a well being situation as a pre-existing situation to solely approving a partial quantity.
“In a number of circumstances cited by coverage holders, it took 10-12 hours after the affected person was prepared for discharge for them to truly get discharged as a result of the medical insurance declare was nonetheless getting processed,” it stated.
The survey stated 39 per cent of these shopping for or renewing normal insurance coverage insurance policies achieve this by means of an agent, 40 per cent rely on on-line aggregators and 14 per cent by means of web sites or apps of insurance coverage firms.
