Claim Repudiated Vs Rejected
In the annual report of IRDAI, Under the STATUS OF INDIVIDUAL DEATH CLAIMS OF LIFE INSURERS, there are two columns - Claims Repudiated & Claim Rejected. What is the meaning of claim repudiated and what is the difference between these two?
Hi Swati,
A Repudiated Claim means 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
Refutation of Claims: Repudiating an insurance claim means that the insurer completely denies responsibility for the claim. The safety net provider affirms that the case isn't covered under the agreements of the insurance contract, or there might be other substantial purposes behind the forswearing. In essence, the insurance provider is stating that they are under no obligation to cover the claim.
Claim Rejected: While claim rejection and claim repudiation are similar, they can have slightly different meanings. When an insurance company denies a claim, it usually means that the company has looked over the claim and determined that it is incomplete, does not have all of the necessary documentation, or does not meet certain requirements. If this is the situation, the claim may be temporarily denied until the policyholder provides the necessary information or meets the required criteria. Although the claim cannot be processed in its current state, the rejection does not necessarily mean that it will be denied forever.
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My medi assist health insurance claim has been repudiated and awaiting for insurer for review . What is the meaning of it and how much time will it take for review.
Hello Swati,
As per my knowledge, these words are confusing for any normal person.
Claim Repudiated means when you submit 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 Raj