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Claims

Common Health Insurance Claim Mistakes

BimaParichay Awareness Team · 4 August 2026 · 4 min read

Most claim friction comes from a small number of avoidable issues — and almost all of them are decided long before the hospital visit.

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Mistakes seen most often

  • Not disclosing existing medical conditions at the time of purchase.
  • Assuming a hospital is in the network without checking.
  • Missing the intimation timeline mentioned in the policy.
  • Incomplete documents — missing discharge summary, investigation reports or original bills.
  • Not knowing about sub-limits, co-payment or a deductible until discharge.
  • Letting the policy lapse and losing continuity.

Simple habits that help

Keep a soft copy of the policy schedule, the insurer or TPA helpline number and the health card on your phone. Inform the insurer as early as possible, ideally before a planned admission.

An honest caveat

No preparation guarantees a claim outcome. Claim decisions are made by the insurer under the policy terms and applicable regulation. Preparation reduces avoidable problems; it does not override the contract.

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