Having health insurance is the best way to protect yourself and your family. If you are injured or fall ill and you don’t have the right insurance in place, you will find yourself with a big bill to deal with. Unfortunately, health insurance isn’t a one-size-fits-all solution and there are some situations when it won’t pay out. People get caught out by this because they assume that their insurance will cover them, and they end up in financial trouble. Knowing when your insurance company is likely to deny your claim can make planning for health costs much easier. So, why won’t your health insurance company pay your claim?
Different Interpretation Of The Policy
Sometimes, the insurance company will dispute your claim because they have interpreted a certain clause in the policy differently from you. It’s important that you understand the specific details of your policy, and how it is supposed to work. If there are any hidden clauses or technical terms that you don’t quite grasp, take some time to ask the insurer for help. In some cases, their interpretation is fair and there isn’t much you can do. However, if you think they are being unfair, you should contact some insurance claim attorneys right away and discuss the situation with them. They may be able to help you fight the insurance company and get your claim paid. But you can avoid this situation in the first place by making sure you understand your policy.
The Treatment Isn’t Covered By Your Policy
So your treatment is finished, and you’re feeling better. But then the medical bills start rolling in and it turns out that a significant portion of your treatment isn’t covered by your policy. You had no idea that this was going to happen because everything seemed fine when you first got the bill. Unfortunately, this is something you need to be aware of as it can happen at any time. Again, this comes down to not reading the policy to see which treatments are excluded. Never assume that everything is covered and always make sure you know what you will have to pay for yourself.
You Provided False Information
This one can come as a shock, especially if you have always been honest about your medical history. However, the insurance company will investigate everyone’s claim to be on the safe side. This is why it is so important to provide accurate information during the application process. The more truthful you are, the less likely it is that there will be any problems later down the line. People often find themselves in this situation when they don’t inform the health insurance company of any changes to their health or life circumstances. This will be considered providing false information, so always keep them updated. Even if it’s just a small change and you don’t think it will really affect your insurance, it’s still best to be on the safe side and let them know, so you always get the full benefits of your health insurance.
It can leave you in a very hard situation if your claim is denied, so make sure to avoid these situations if you can.