Health Insurance Claim Rejected? Your 2026 Fight-Back Plan
Do not accept the first rejection at face value, do not miss the GRO window, and do not discard medical records or hospital bills - they are your appeal evidence.
Section 45 advantage
For life policies, Section 45 of the Insurance Act 1938 bars contest after 3 years of continuous coverage except for proven fraud - a powerful lever on older claims.
Why claims get rejected
Non-disclosure of pre-existing diseases, incomplete waiting periods, policy exclusions, lapsed policies, delayed intimation, and missing documentation cause most rejections. The insurer must state the reason in writing - demand it if absent.
Step 1: Written rejection letter
By regulation the insurer must provide a written rejection citing the specific policy clause. If they have not, write a formal letter demanding one and keep every communication with dates.