Health insurance is meant to give peace of mind during tough times — but when claims get delayed or rejected, it adds stress instead of relief.
At Eternity Claim Solutions, we help you in getting the insurance claim you rightfully deserved. We help you take up your grievances at appropriate levels of Greivance Redressal.
We are Completely Digital.
Why Health Insurance Claims Get Rejected?
A health insurance claim rejected case commonly occurs when a policyholder has a
pre-existing medical condition that was not disclosed at the time of purchasing the
health insurance policy. Non-disclosure—whether innocent or intentional—may lead to
medical claim denial and health claim repudiation.
After porting a health insurance policy to another insurer, claim processing may involve
additional checks. If any discrepancy or incomplete documentation is found, the
mediclaim may be rejected during claims processing due to porting-related complexities.
Many policies include specific waiting periods. If a claim is filed within this tenure, the insurer may issue a
health insurance claim repudiation as per the terms of the policy.
Providing inaccurate, false, or incomplete information during the policy application can lead to
medical insurance claim rejection. Insurers rely on correct details to assess risk.
Every health insurance policy has specific exclusions. If the treatment or condition falls
under these exclusions, the insurer may reject the medical claim.
Failure to disclose important medical history, past treatments, or lifestyle habits can result in a
health insurance claim rejected decision. Non-disclosure is one of the leading causes of
insurance grievance cases.
If the policyholder fails to pay premiums and the policy lapses, any claim made during this time will be rejected.
A health insurance claim rejection is guaranteed if the policy is not active.
Understanding the terms of your health insurance policy, including waiting periods and exclusions,
and submitting accurate information can help avoid medical claim rejection.
Understanding the terms of your health insurance policy, including waiting periods and exclusions, and submitting accurate information can help avoid medical claim rejection.
By choosing Eternity Claim Solutions, you ensure:
FAQs – Simplifying Insurance for You
You should file a grievance if your health insurance claim has been unfairly rejected, delayed, or partially settled without proper justification, or if the insurer’s customer service has not responded to your issue within the given time frame.
You can raise a grievance by contacting the insurance company’s grievance cell through email, phone, or their official grievance portal. If you are not satisfied with their response, you can escalate the issue to IRDAI’s Grievance Cell (IGMS) or approach Eternity Claim Solutions for Helps if you Think You are not well versed with the process.
You typically need:
Your policy copy
Claim documents and rejection/settlement letter
Communication with the insurer (emails, letters, etc.)
Medical records or bills related to the claim
Providing complete and accurate documents helps resolve the issue faster.
Yes. If your claim was rejected due to a documentation error, miscommunication, or a wrong interpretation of policy terms, it can be reopened and reconsidered with proper justification and support documents.
Ask for a written explanation from your insurer
Appeal the rejection
File a complaint with the grievance cell or regulatory body
Our legal team ensures your rights are protected and your claim is properly represented.
Eternity Claim Solutions reviews your entire case, identifies the reasons for rejection or delay, prepares a strong representation and helps you coordinate with the insurer to ensure that you get your rightful claim settled.
Why Choose Eternity Claim Solutions?
🕒 Quick & hassle-free Communication
📞 Dedicated claim assistance team
⚖️ Expert legal and documentation support
🔍 Transparent process with regular updates
🤝 100% ethical and client-first approach.
💼 Support for all insurance types (Life, Health, Motor, Fire, Corporate, etc.)
