How senior citizens can avoid health insurance claim rejection

senior citizen


One of the main reasons why people opt for insurance is to get a sense of financial security and some peace of mind. However, everything becomes null and void for the policyholder if he/ she faces challenges during claim settlements. Talking about senior citizens, they are a lot more disadvantaged, compared to the ones in their working years. The loss of regular income and dependence on savings/ pensions make insurance, even more vital for their smooth survival. 

Senior citizens usually end up paying a premium, which is almost five times more than someone in their 30s (for the same coverage). Especially, in the health segment, they usually have higher spends on medical expenses, longer hospitalization stays and pay a lot more on medications and doctor consultations. A lot of work is being done in introducing newer products for senior citizens (specially in health insurance); and helping them with claim settlements. However, there is scope for more work, as this population segment is very vulnerable. Insurance companies, intermediaries and hospitals need to take proper care, while settling claims for the senior citizens. 

While the industry is doing their bit to help seniors, the latter should also carefully evaluate their policies and know about certain terms and conditions, so that their claims do not get rejected. 

Submission of complete information

All necessary information related to past medical history, family history, details of important assets, important bills, copies of insurance cards should be submitted. Many a times, senior citizens face challenges with clarity on the documents that need to be submitted. Insurance advisors can be of great help here, as they can guide senior people on all the relevant documents and help them with the end-to-end process of form submission.  

Also Read: Tenants must purchase insurance to protect their home contents. Here is why

Understanding all the policy terms and conditions

Insurance policy documents are usually lengthy and detailed. Even the younger population choose to read the terms and conditions superficially; and miss out many valid points in the due process. It is quite common and expected that the senior people miss out on important information while understanding terms and conditions. Unfortunately, it is during claim settlements that they become aware of such T&C. The role of insurance advisors become crucial here, as they can guide consumers with minute details around do’s and don’ts in the policy document. 

Renewal of Policy

Insurance providers have a waiting period for certain medical conditions and their treatments; and senior citizens should be aware of the duration of the waiting period. They should also analyse the renewal policies, so that the insurance coverage remains valid after the renewal period, and they do not face challenges with claim settlements. 

Customer Support and company reviews

This is very significant that senior citizens do some research on the insurance company’s customer support system and its efficiency and read reviews to evaluate their future experience. Digital has made things convenient these days, where seniors can easily access online reviews and get a basic understanding of the insurance company and its services. Credible insurance / InsurTech companies are usually backed by a strong customer support team, which is extremely important for seamless claim settlements. 

Also Read: ‘Impact of new tax on non-Ulips likely to be marginal’

Claim settlement has never been easy, either for the insurance provider or the consumer. Consumers can face challenges with claim settlement, across geography and demography. However, the process can be made simpler for consumers, and especially for senior citizens, if they take the route of digitally enabled insurance advisors. Advisors of InsurTech companies play a contributory role in giving unbiased guidance to consumers on the right kind of policies and help them with the end-to-end insurance process- starting from documentation to explaining necessary information, so that the latter do not face challenges during the settlement process. 

This article has been written by Indraneel Chatterjee, Co Founder, RenewBuy. Views expressed are personal


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