A life insurance policy is an essential tool to help safeguard your family’s future in the event of your passing. The last thing you’d ever want is to put in a claim and have it denied, especially during an already difficult time. Still, the unfortunate reality is that insurers do reject claims from time to time. This is why it’s important to know the terms and conditions relating to your policy to ensure your family receives the coverage that can assist them when they need it the most.
What Can Cause My Claim To Be Denied?
Non-Disclosure
Non-disclosure occurs when the policyholder fails to provide essential information about their occupation, health or medical history to their insurer. Even unintentional non-disclosure can jeopardise your claim, making it crucial that you keep your insurer up to date on any relevant changes. As an example, if you took out a policy while in good health but later discovered you had a heart condition or diabetes, or if you initially declared yourself as a non-smoker but started smoking later, it could affect your claim's validity.
Failure to meet claim requirements
Submitting the required documents is essential for a successful claim. Depending on whether the life insured’s passing was accidental or natural, specific documents will have to be provided. These may include a fully completed claim form, a certified copy of the death certificate, a completed DHA-1663 form (this is a form you need to fill in to receive a death certificate), certified copies of the beneficiaries' identification, 3 months' bank statements for all beneficiaries, and a police report in the case of an unnatural death.
Non-payment of premiums
It’s essential that you keep up with your life insurance policy’s premium payments to maintain insurance coverage. If the policyholder's premiums are not up to date or if the policy has been canceled before the policyholder's passing, the insurer may deny the claim. In the event of a late payment, most insurers will notify you about it and give you a grace period. If you have a life insurance policy with MiWayLife, we’ll give you 15 days grace to pay for the missed payment. You’ll also get to benefit from our 4-in-1 policy that includes funeral cover – all for one monthly premium.
Suicide within the waiting period
It’s a common misconception that life insurers won’t pay out in the event of a death by suicide. They can – but most insurance policies have a waiting period, during which the policyholder needs to be covered for a certain number of months before being eligible to make a claim. Typically, this waiting period is around 24 months. If the policyholder passes away due to suicide during this time frame, the claim may not be paid out.
Engaging in exclusions listed in the policy
All insurance policies come with a list of exclusions, specifying circumstances under which the insurer will not provide coverage. These could include travelling to war-torn countries, participating in risky activities like cliff jumping or riots, committing crimes, taking medication that hasn’t been prescribed by a doctor or drinking and driving. Engaging in any excluded activities can lead to claim rejection which is why it’s important to read your insurance policy’s terms and conditions carefully and live within its limitations. Remember, they’re all geared towards keeping you healthy and alive.
