The reason why the claim is not paid

Below there are several reasons why an insurance claim is paid :

• Not included in clause (contract), for example: accidental death, but in fact the customer died of natural causes dies then the claim will not be paid
• Included in the exceptions, for example: some types of cancers such as skin cancer, prostate, etc. (each insurance company sets different types of cancer that can not be claimed. Or die for committing the crime, was also included in the exceptions
• Existing disease, if the diagnosis is known that the claim is filed due to illnesses that existed before the policy applies and is not listed in the policy, then the claim is not paid.
• The document is incomplete. Completeness of the documents required when a claim such as: medical certificate, the letter claims from customers themselves. Lack of any one document then the claim will not be paid.
• Still in the waiting period. Several types of claims such as critical illness, the hospital requires a waiting period (time after sunrise policy) between 30-365 days. If the disease that claimed the waiting period included in the claim not being paid.
• Policyholders in a state of lapse. Lapse, which means the policy is not active yet because of unpaid premiums due the insurance company will not pay claims filed.
• Claims filed later than the time specified. Usually, insurance companies set a deadline for claims between 30-60 days, later the claim would not be served.
• Claims filed due to the customer to commit a crime. For example: admission because he was beaten while stealing mass.
• Crime insurance, for example: accidentally cut his own finger to get reimbursement. Or heirs who commit crimes against the insured claims that considering the amount of money will be obtained.
• Being outside the contract territory. For example: in a written contract all the events that occurred in Indonesia, but in fact there are events outside of Indonesia then the claim will be rejected.

Seeing the many reasons for unpaid insurance claims, it is important for policyholders to study the contract carefully because every life insurance companies have different asuransi.