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Claim Repudiated Vs Claim Rejected

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17 Sep, 2021 by  Swati

In the annual report of IRDAI, Under STATUS OF INDIVIDUAL DEATH CLAIMS OF LIFE INSURERS, there are two columns - Claims Repudiated & Claim Rejected. What is the difference between these two?

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Term Life Insurance
Claim
Basics of Insurance

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18 Sep, 2021
Kaushik Amrit Raj

Hello Swati,


As per my knowledge these words are confusing for any normal person.


Claim Repudiated - when you submit for any claim in life Insurance, the condition or the cause of loss is not covered under the policy and there is no scope for payment of the claim, hence it is completely repudiated by the insurance company.


Claim Rejected - Let's say you submit for a claim under life insurance and the policy T&Cs say that the cause of loss is covered and you submitted documents for the same to get the claim amount but later on there is some discrepancy and the insurer denies your claims on such ground saying due to insufficient documents or bills or late submission etc. we cannot process your claims.


I hope it clear your doubts...



Thanks,

Kaushik Amrit aj





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24 Sep, 2021
Swati
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18 Sep, 2021

Hi Swati,


Claim Repudiation would mean that the insurer is of the opinion that the claim under the contract of insurance is not admissible either due to non fulfillment of the terms of coverage or due to any fraud / misrepresentation.


Claim Rejection would generally imply unconcluded cases beyond the specified timeframes due to non availability of any documentations.


Hope it clarifies.


Regards

Krishnan

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