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Moneycontrol07-01-2026, 13:12

Critical Illness Claim Rejected? Don't Give Up! Steps to Get Your Payout

  • Critical illness claim rejections are often procedural, not permanent, usually due to policy wording, waiting periods, or unclear medical records.
  • Thoroughly review your policy document, focusing on covered illnesses, exclusions, and specific definitions to understand the criteria.
  • Request a detailed explanation from the insurer, including the rejection clause, and maintain a written communication trail for all interactions.
  • Collaborate with your treating doctor to ensure medical records accurately reflect your condition as per policy definitions, addressing any gaps.
  • Escalate unresolved claims through the insurer's formal grievance process or the insurance ombudsman for a fair and low-cost resolution.

Why It Matters: A rejected critical illness claim isn't final; persistence, documentation, and escalation can lead to approval.

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