Jakarta –
It’s not long over Indra Bekti undergoing surgery for a brain hemorrhage, his wife Aldila Jelita managed to raise funds to help treat her husband at the hospital. This drew attention from the wider community.
Related to this problem, many people ask whether the presenter does not have insurance to cover the cost of the treatment. However, the family claimed to have filed an insurance claim but was rejected.
“I asked his team, there was insurance, but it was declined. It failed, why I don’t know,” said Cipta, Indra Bekti’s sister, met at Abdi Waluyo Hospital, Menteng, Central Jakarta, Monday (2/1/2023).
The claim process itself is an official submission from the insured party to the insurance company to request reimbursement of costs, but there are various reasons that can cause the insurance company to reject our claim.
One of them can happen because we carry out medical treatment at a non-insurance partner hospital concerned. It might also be because we ignore the exclusion conditions or existing insurance policies.
To be clearer, launching from the Manulife insurance company website, here are a number of things that can cause an insurance claim to be rejected:
1. Risks Not Covered by Insurance
Each insurance product has different benefits, and all of them are listed in the insurance policy. For example, there is health insurance that has coverage benefits for inpatient care and outpatient care only, and some have both benefits.
Because it is very important for us to understand what are the benefits, as well as the types of risks that are indeed borne by the insurance that we have.
2. Not in accordance with the Policy Requirements
Please note, each insurance plan has conditions for the disease covered. Well, it might be, there are several diseases that are not covered by health insurance or critical illnesses that make insurance claims rejected.
3. Data Received by Insurance Does Not Appropriate
Most likely, the health data of the customer concerned in SPAJ (Request for Life Insurance) or SPAK (Request for Health Insurance) is incorrect.
For example, someone has a history of serious illness within a certain period of time or has had surgery. But when filling out the request letter, he was dishonest.
In fact, the contents of SPAJ and SPAK will greatly affect the value of the premium that must be paid. Dishonesty in filling out the form can actually cause insurance claims to be rejected.
4. Exceeding the Deadline
In a health insurance policy, we are required to apply for reimbursement within a certain period of time according to the provisions of the policy. If you don’t file within the allotted time, insurance claims can be rejected.
Also see the video ‘The Right Steps to Create a Bright Future for Children’:
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