Dos and Don’ts When Making Critical Illness Insurance Claims

Insurance, they say, is something you buy to cover something you hope won’t happen. You buy insurance not hoping that the covered event will happen. Rather, you buy the cover to protect you when it does happen. The time when you need to make a claim is a time that you dread, but sometimes can’t avoid.

Here are some simple dos and don’ts you need to remember in order to make your critical illness insurance claim smooth and hassle-free.

Do:

• Give full disclosure. Although it’s too late for this, it is important to note that you need to give your actual health status at the time of your application. Failure to do so may mean that the insurance company can deny your claim due to the fact that you did not fully disclose your health condition.

• Get documentation. It is best that you keep careful records of your health status. You may need to present these when you make a claim. Provide evidence that you have indeed been diagnosed with a covered critical illness. You may need to present a document from a doctor that is a specialist of the illness that is diagnosed.

• Inform your insurance company at once. Once you are diagnosed with a health condition that’s covered by the critical illness insurance policy, you need to inform your insurance company about this, so that you are informed as to what documents you will need to make your claim.

• Be prepared to make an appeal if your claim is denied. In case your claim gets denied, you can still make an appeal.

Don’t:

• Assume that you are covered. It is important to know exactly what your policy covers. There may be differing definitions of a covered illness, so you need to check the details in your policy and how it defines the illness you are claiming against.
  Remember that the company will pay only if your claim falls under the definition of the policy. For instance, there are some cancers that are not covered – some cancers that are not critical and may be treated will often not be payable under the critical illness policy.

• Fail to pay your premiums. Again, this may be late in the game, but your failure to pay your premiums after the grace period may mean that your policy is no longer in force.

• Make any fraudulent claims. For one, the insurance company will thoroughly check the veracity of your claim. If they find out that you have been making a false claim, they will deny your claim. Also, they may “blacklist” you and this may affect any future applications to other insurance companies.

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