Imagine you’ve got a health insurance plan, and suddenly, you’re hit with a hospital bill—say ₹2 lakh for an emergency surgery. You breathe easy thinking, “My insurance will cover this.” But then, the claim gets rejected, and you’re left scrambling. Sounds like a nightmare, right? Sadly, it happens more often than you’d think, all because of some common mistakes in insurance claims. In India, where we rely on insurance for everything from medical emergencies to car accidents, avoiding these slip-ups can save you time, money, and a whole lot of stress.
Whether it’s a bike insurance claim after a monsoon skid or a life insurance payout for a loved one, the process can feel like a maze. But don’t worry—we’re here to point out the potholes so you can glide through smoothly. Let’s dive into the top mistakes people make and how to dodge them.
Why Insurance Claims Go Wrong
Insurance is like a safety net—it’s there to catch you, but only if you use it right. In India, with our mix of paperwork woes, busy lives, and sometimes tricky fine print, claims can hit a wall fast. A small goof-up—like forgetting a receipt or missing a deadline—can turn “approved” into “rejected.” Knowing these traps ahead of time is half the battle won.
Top Common Mistakes in Insurance Claims
Here’s what trips up most folks—and how to steer clear.
1. Not Reading the Policy Properly
You sign up for insurance, toss the papers in a drawer, and forget about it. Big mistake! That fine print tells you what’s covered—like cashless hospitals or accident types—and what’s not.
- Example: Raj in Mumbai thought his health plan covered dental work. Turns out, it didn’t—claim denied, ₹30,000 lost.
- Fix: Spend 10 minutes reading the policy—or ask your agent to explain key points. Look for exclusions (what’s not covered) and conditions.
Why It Happens: We assume “full coverage” means everything. In India, policies often skip things like OPD visits or wear-and-tear repairs unless specified.
2. Missing Claim Deadlines
Every policy has a clock ticking. For health insurance, you might need to notify within 48 hours of admission or submit bills within 30-60 days. Miss it, and you’re out of luck.
- Example: Priya’s car got damaged in a Pune flood. She waited 3 months to file—past the 30-day limit. Claim rejected.
- Fix: Check your policy for deadlines (usually under “Claims Procedure”). Set a phone reminder—don’t delay.
Why It Happens: Life gets busy—hospital stress or repair chaos—and we forget. Insurers stick to deadlines to avoid fraud or stale claims.
3. Not Reporting the Incident Promptly
Delaying that first call or email to your insurer is a classic blunder. Whether it’s a bike crash or a hospital stay, they need to know ASAP.
- Example: Anil’s bike was stolen in Delhi. He reported it to the police but told his insurer a week later—claim denied for late intimation.
- Fix: Call the helpline (on your policy card) within 24-48 hours. File an FIR for theft/accidents and share the number with them.
Why It Happens: We focus on fixing the problem (hospital, police) and forget insurers need a heads-up to start their process.
4. Submitting Incomplete Documents
Insurance claims need paperwork—think bills, FIRs, or discharge cards. Miss one, and it’s like serving half a thali—rejected.
- Example: Meena’s health claim in Chennai got stuck because she forgot the doctor’s prescription with her bills.
- Fix: Make a checklist—policy number, ID proof, bills with stamps, claim form. Double-check before submitting.
Why It Happens: In India, we’re used to jugaad, but insurers want every paper in place to verify your claim.
5. Lying or Hiding Information
Exaggerating a loss or hiding facts—like a pre-existing illness—seems tempting but backfires hard. Insurers dig deep.
- Example: Vijay claimed a ₹50,000 phone theft but said it was new. It was 2 years old—claim denied after investigation.
- Fix: Be honest. Declare health conditions when buying, and stick to facts in claims—truth pays off.
Why It Happens: We panic about rejection or want more cash. But fraud flags kill your credibility—and claim.
6. Ignoring Cashless Options
Many health or motor policies offer cashless claims—hospitals or garages settle directly with insurers. Skipping this means shelling out cash and chasing reimbursement.
- Example: Sunita paid ₹1 lakh upfront at a non-network hospital in Kolkata. Reimbursement took 3 months—and a fight.
- Fix: Use network hospitals/garages (list’s in your policy). Call the insurer first to confirm cashless.
Why It Happens: We rush to the nearest place in emergencies, forgetting network benefits save hassle.
7. Not Keeping Copies of Documents
You hand over originals to the insurer and—poof—they’re lost. Now what? No proof, no claim.
- Example: Rohan in Hyderabad submitted his car repair bills. Insurer misplaced them—claim stalled for weeks.
- Fix: Scan or photocopy everything—bills, forms, FIR. Keep a digital folder or hard copies.
Why It Happens: Indian paperwork can be chaotic—banks, insurers, hospitals lose stuff. Protect yourself.
8. Forgetting to Renew On Time
Lapsed policy? No coverage. A common slip, especially with annual plans like PMJJBY or bike insurance.
- Example: Kavita’s health policy lapsed in May 2025. She fell ill in June—₹80,000 out of pocket, no claim possible.
- Fix: Set a calendar alert a month before renewal. Auto-debit helps—check your bank balance!
Why It Happens: Busy lives—new job, wedding prep—and we miss the date. Insurers don’t bend on this.
9. Not Following Up on Claims
You submit and wait… and wait. Meanwhile, your claim’s stuck because of a missing signature or a query.
- Example: Amit’s bike claim in Bangalore sat for 2 months—he didn’t check. A quick call could’ve fixed it.
- Fix: Track online (most insurers have portals) or call weekly. Note claim numbers and names of reps.
Why It Happens: We assume it’s automatic. In India, delays are common—stay on it.
How to Avoid These Mistakes
- Know Your Policy: Read it once—10 minutes saves lakhs.
- Act Fast: Report and file on time—phone’s your friend.
- Be Thorough: Double-check docs, keep copies.
- Stay Honest: Truth beats trouble every time.
- Follow Up: Don’t let it sit—push gently.
Final Thoughts
Avoiding common mistakes in insurance claims is like prepping for a monsoon—you don’t wait for the rain to fix the roof. In India, where insurance is our shield—be it ₹2 lakh from PMJJBY or a car repair claim—small slip-ups can cost big. Picture Ravi from earlier: if he’d read his policy, reported on time, and kept receipts, that ₹2 lakh bill would’ve been covered, not a burden.
So, next time you’re filing a claim—health, life, or motor—go slow, check twice, and keep it real. Your insurance is there to help, not haunt. Ready to claim smart?
FAQs on Common Mistakes in Insurance Claims
1. What’s the biggest mistake in insurance claims?
Not reading your policy—missing what’s covered or deadlines can sink your claim fast.
2. How late can I file a claim?
Depends—health claims often need notice within 48 hours and docs in 30-60 days. Check your policy—late means lost.
3. Why do insurers reject claims?
Late filing, missing papers, lying, or lapsed policies. Stick to rules, and you’re golden.
4. Can I claim without bills?
Tough—insurers need proof like bills, FIRs, or discharge cards. No docs, no dice.
5. What if I forget to renew my insurance?
No renewal, no coverage—claims get rejected flat. Set reminders or auto-debit to stay safe.
6. How do I avoid delays in claim processing?
Report ASAP, submit all docs, and follow up weekly—call or check online. Don’t let it sit.
7. Is it okay to exaggerate a claim?
No! Insurers investigate—fake details mean rejection and maybe legal trouble. Keep it honest.
