7 causes For Insurance Claim’s Failures ( Unpaid )

In this article, I would discuss any of causes for unpaid insurance claim to the customer.

Customer Mistaken

Not every of claim payment failures were caused by insurance company. Its can be caused by the customer personally too.
Generally, there are five customer's mistakes that can cause for the Insurance claim’s failure :

1.Customer dishonesty

Before someone had the Life Insurance product, previously he must fill up the request form for Insurance. There are many questions that must be answered by a prospective customer, and from that answers the insurance company will consider whether giving the Life Insurance protection’s to you or not.

When filling up, prospective customer did not give the true answer often.For example, the question about: Whether you had been treated in Hospital for the last two years. If you answer no, but in fact you had been treated in hospital for the last six months for example. Then when the death happen to you and insurance company found that the cause of your death is because of the existence of the illness that had made you been treated in the hospital around the last six months, and so don't hope for the insurance company will pay the claim that was promised by them.

2. The exception by insurance company for paying claim.

Sometimes insurance company did not give the benefit promised by them when the cause of your death was exempted (and the exception was written in the policy).
Concerning for this exception, many insurance company determine the number of varying exceptions. However, generally is:
- The death because of the suicide
- The death because of the person doing the criminal act
- The death because of the AIDS
- The death because of the critical illness, where the death happened in the first year since he joint the insurance program.
- The death because of force majeure
Or other matters that could not be avoided, like the war, the natural disaster, or the riot.
The customers did not read these exceptions in the policy often, so it has become the loss for them. Therefore, if you had the Policy of the Insurance, make sure to read the available articles in the policy.

3. The customer was too long to submit their claim.

Generally, insurance company determine the limitation time for the insurance claim’s submission. Usually, the time is limit to be three months. The customers often lodge the claim out of this deadline, so as the insurance company wont pay you. For example, your husband joined a life insurance program with you as his heir. When the death happen to your husband, happening then you could get the benefit of the insurance that was promised if your claim submission still in the deadline of three months after his death. If you did not, the insurance company possibly will not give the benefit that promised by them.

Now, how you could know the limitation time that given by your insurance company for lodging the claim? You could read it in your insurance policy.After that, if later the death is happen, then lodge your claim immediately to insurance company.

4. The Conditions during the claim submission were not complete

Insurance company usually asks for several conditions during the claim submission whenever the death is really happened to their client. That Conditions usually not equipped by the customer's heir, so as the insurance company cannot pay their claim immediately.

Commonly, the conditions that were asked by insurance company when you lodge the death claim are:
- The certificate of the death
- The certificate of the Accident from police (if the death happened because of the accident)
- The certificate from Hospital (if the death happened in Hospital), where the letter was signed by the relevant doctor
- Filled up the form of the claim submission published by insurance company
- Make copy of the Identity So, when the risk of the death happening, don't forget to meet all the conditions that were asked by insurance company. It is not difficult right?

5. The customer not paid the premium in a certain period that has been determined.

It is clear, if you did not pay the premium in accordance with the period that was determined, it could be your insurance policy being expired. That mean you are no longer protected by the insurance. This is that often happened. In the beginning, customer paid the premium regularly, but at one time, the premium is no longer paid, until the certain deadline. This is just the same as if you used electricity and did not pay its bill in the certain deadline, so as your electricity might be interrupted.

Because of that, make sure you know about the premium payment regulation.Do not let your insurance policy not claimable just because you forgot to pay the premium right on time.

Insurance Company Fault

Beside the mistaken from customer, the claim failure also could be caused by the insurance company mistake. There are several mistaken actually, but that was general happened only two:

1. The insurance agent dishonesty in presenting insurance product.

It could be that your insurance agent was dishonest in presenting the insurance product. For example, in presentation he said that insurance company would pay the life insurance claim when the death was caused by the critical illness, including if this risk happened in the first year.In fact it is not like this generally.

It is true that not every insurance company had the same policy. So my suggestion is what is seen and written in your insurance policy that is must be made for your reconciliation, not from the insurance agent said. Generally, insurance company gave a money back Guarantee if evidently you are unsatisfied against the articles that were printed in the policy. You could return its policy, and your money will back. Of course, as long as the return of the policy is in the certain period limitation, that determined by the insurance company, that usually 30 to 90 days.

Then, does all the insurance agents are can’t believed? Of course not. That is depend on the agent personally. Don't just because of having one agent that dishonest, then you compare all the insurance agencies in this world as a same kind. Once more, all that is depend on their respective character.

To prove whether the presentation by the life insurance agent is true, all you need to do is compare with the insurance policy. If it same, that meant your insurance agent is honest and could be believed. When is not, reported to his insurance company.

2. The Insurance company denial.

If you have met all the conditions that were asked for, honest in filling up the claim form, paid the premium regularly, sent the claim submission still in a limitation period, but your claim still not being paid, it could be the insurance company have to deny their liability. Then when it is possible you can hire an attorney to help you out.