As adults with financial obligations, it’s crucial to safeguard our income. However, people often realize the importance of income protection insurance only after experiencing unexpected events such as critical illnesses, accidents at work, or loss of employment. Despite its benefits, not all claims made for income protection insurance are successful. This article discusses the common reasons for income protection claim rejections and offers tips on how to avoid them. So whether you have already taken out an income protection policy or have plans of obtaining one in the future, read on to arm yourself with the necessary expert knowledge.

Reasons for income protection claim rejection

Non-disclosure of Pre-existing Medical Conditions

To avoid claim denial on the grounds of non-disclosure, it is crucial to reveal all medical conditions when applying for a policy. Applicants must be honest and transparent when answering medical questions and provide complete and accurate information about their medical history to ensure that the insurer is aware of any potential risks.

Failure to attend medical appointments

Income protection claims are also often rejected when the insured fails to attend medical appointments related to their claim. Missing appointments can hinder the claim process since insurers often require medical evidence. Missed appointments may even suggest that the claimant is not taking their medical condition seriously.

Incorrect information provided on the application

Inaccurate information provided on the application form is another frequent reason for income protection claim denial. To prevent miscommunications or misunderstandings between the policyholder and the insurer, it is critical to be precise and truthful while completing the form. Any omission, false statements, or incomplete information, such as employment status, job responsibilities, and income levels, may result in the claim being rejected.

Insufficient evidence to support the claim

One of the common reasons for income protection claim rejection is insufficient evidence to support the claim. The insurer may require specific documents or medical records to prove the validity of the claim. If the claimant fails to provide adequate evidence or proof of their illness or injury, the claim may be denied.

Policy no longer active or unused

Income protection claim rejection can also occur if the policy has lapsed or become inactive due to non-payment of premiums or neglecting the policy. It is crucial to keep track of the policy and make timely premium payments to keep the policy active. If the policyholder no longer requires coverage, they should cancel the policy properly to avoid lapsing.

Missed premium payments

Missed premium payments can lead to income protection claim rejection, as it could result in the policy no longer being active or unused. Policyholders must keep up with their premium payments to avoid any interruptions in coverage.

Injury or illness not covered in policy terms

Denial of an income protection claim is frequently due to the injury or illness not being included in the policy’s terms. It’s worth remembering that not all policies cover the same illnesses or conditions, such as back injuries or treatable cancers. Individuals must inquire about such details with their insurance providers and thoroughly review the terms and conditions of the policy before deciding to purchase it.

How to avoid income protection claim rejection

Provide accurate and complete medical history

Providing an accurate and complete medical history is crucial to avoid income protection claim rejection. Non-disclosure of pre-existing medical conditions is one of the most common reasons for claim denial. Therefore, it is essential to disclose everything when filling out the application form.

Double-check application information

To avoid the rejection of an income protection claim, double-check all information provided on the application to the policyholder is responsible for ensuring that everything they have disclosed in the application is accurate and true. Any incorrect or incomplete information could lead to a claim rejection, and insurers may also view incorrect information as an attempt to deceive them.

Understand the policy’s definition of disability

Understanding the terms and conditions of a policy is crucial as it specifies the specific circumstances or conditions under which a claim will be approved. It is essential to read and comprehend this section of the policy to ensure that any claim made is within the policy’s guidelines. For instance, the definition of disability may vary from one policy to another; some may consider disability as the inability to work in your current job, while others may define it as being unable to work in any job at all.

Comply with policy requirements

Policyholders must ensure that they abide by all the terms and conditions outlined in their policy document, including meeting deadlines for submitting relevant documentation and adhering to the specific process outlined for making a claim. Failure to comply with any of these requirements may lead to a denied claim.

Disclose all pre-existing medical conditions

It is imperative to provide full disclosure of any pre-existing medical conditions when purchasing an income protection policy to avoid claim rejection. Failing to disclose or only partially disclosing these conditions is a primary reason why income protection claims may get denied. Therefore, it is essential to provide accurate and complete medical history upfront when applying for the policy to ensure that the insurer has all the necessary information.