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Link: https://www.probusinsurance.com/health-insurance/health-articles/can-claims-be-rejected-if-the-insured-wasnt-aware-about-his-pre-existing-or-life-style-disease/

Can claims be rejected if the insured wasn’t aware about his Pre existing or life style disease?

He had taken his health policy in the year 2011 and had been regularly paying his premiums. In the fourth year that is 2014 he went for “coronary artery bypass grafting” surgery.

Now here lay the catch.The hospital discharge card mentioned Mr. Shetty as suffering from diabetes along with hypertension. This gave the insurance company a reason to reject his claim, stating that hypertension along with diabetes was a pre existing condition. The company also went to the extent of stating that he had not mentioned his condition when he took the policy in the year 2011, thus hiding the facts.

Mr Shettys contention was that he was not suffering from any pre-existing ailment in 2011 and had shared his family doctors written statement to support the same. Inspite of providing all the relevant documents, the company rejected his claim. This is when he decided to take expert guidance on the matter and shared his case details with me.
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Can claims be rejected if the insured wasn’t aware about his Pre existing or life style disease?

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Found: 21.10.2020

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