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Why Does Your Health Insurance Application Get Rejected?

By Vikas Chandra Das
21 July 2022, 11:46 AM
why does your health insurance application gets rejected

Medical emergencies are unprecedented and can drain you out of all of your savings. A health insurance policy would help you in providing financial security during times of medical emergencies. With online health insurance policies, it has become quite easy for everyone to purchase health insurance policies, renew them, and also raise health insurance claims.

However, your health insurance application can be rejected by the insurance provider and this experience can be quite exhaustive. So, it is imperative to understand the main reasons why your health insurance application can get rejected.

Common Causes for Rejection of Health Insurance Application

1. Incorrect filling of the application form

Not filling your health insurance form properly or providing wrong information is one of the major reasons behind the rejection of health insurance applications. You must be very careful while filling the insurance application form. You should ensure that you are entering the right information and have all the necessary documents to back up your information. This will reduce the probability of your application rejection.  

Tip: Always fill up the form carefully so that all details are filled inaccurately. You must mention details about your health status explicitly so that there is no confusion at the time of filing a claim!

2. Pre-existing conditions

Health insurance providers take up a huge risk when they are providing you with health insurance coverage.  So, in order to mitigate the risk factor, medical insurance providers would try not to provide coverage if you have some pre-existing conditions like diabetes or hypertension. This is because you would be a riskier client if you have some pre-existing conditions and would make several claims too. So, if you have a pre-existing disease, which was diagnosed before you opt for the policy, your health insurance application might be rejected. 
Tip: However, not all plans deny coverage for pre-existing ailments. There are some plans which do provide coverage for pre-existing ailments also. Thus, if you or anyone in your family has a pre-existing disease (PED), try looking for a plan which provides PED coverage even if it is after a certain waiting period.

3. Occupational risks

Health Insurance companies will always be looking out for opportunities to reduce the risks. There are several professions that bring various health issues and scares such as fire-fighting, mountaineering, etc. If you have applied for a health insurance policy and you belong to any of these professions then your health insurance application has a chance of being rejected.
Tip: Not ALL plans have occupational hazards as one of their eligibility criteria.

4. Age limit

In most of the medical insurance plans in India, there is an upper age limit. Usually, this age limit is within the range of 50 years- 60 years for regular health plans and if you are above the maximum age limit while applying for the medical insurance plan your application would be rejected.

Tip: Opt for health plans which fit your age criteria so that it is not rejected on application. There are specific senior citizen health insurance plan available in India for people more than 60 years of age. There are some plans without any age criteria as well. Look out for those options.

5. Medical underwriting 

Before the issuance of the health insurance policy, you would be evaluated on the basis of your medical history to decide on offering the cover or not and also to set the premium rates. This is the process of medical underwriting. Sometimes you might be asked to go for some medical tests, as well. 
If during the underwriting process, there is the diagnosis of any ailments or health conditions then your application can be rejected or postponed. Nowadays, health insurance providers carry out stringent medical underwriting processes, in order to smoothen the health insurance claim process at a later point in time, which has increased the number of health insurance application rejections. 

How to Prevent Your Health Insurance Application from Being Rejected?

You can follow the below-mentioned steps to avoid your health insurance application from being rejected.

  1. You must fill your application form for medical insurance yourself and can also take some assistance from insurance advisors in case of queries. You should avoid getting your form filled by any other person and should check it thoroughly to avoid any mistakes.
  2. You must select those health insurance products where the disclosures required are not general in nature and are specific. Instead of opting for the form of a health insurance provider which has the question “Have you consulted the doctor within the last two years?” You can opt for the form of the insurance provider who lists out the specific ailments and asks to confirm if you suffer from those or not.
  3. Do not add additional information. There is no need to confess about scenarios like your over-weight a few years ago or you have consumed alcohol once in a while. If you have a count, you should pre-underwrite your insurance. Many health insurance providers would look at your current medical records and provide you with an assessment. This would not add rejection as a part of your permanent record and you can approach other health insurance providers too.
  4. You can opt to purchase top-up medical insurance plans which have high deductibles. By this, the initial amount of the expenditure would be paid by you and the remaining would be paid by your health insurance provider. The health insurance provider would issue you the medical plan easily because of this deductible.
  5. Before the medical check-up procedure by the health insurance provider, you can carry out a check-up on your own to find out about any minor illnesses that can cause rejection. Moreover, you can insist on carrying out the medical tests for underwriting in reputed laboratories as it would impact your test results too.


Hence, you must do thorough research before applying for a health insurance policy. You must know in detail about the health insurance provider and its medical plans. It would be easier for you to know what to apply for when you have complete knowledge about the health insurance plan. Even if your health insurance application gets rejected, you should not feel distressed and must try it with another insurance provider. There are several health insurance providers who are quite eager to sell their health insurance plans. You must do thorough online research and also take assistance from insurance advisors. This would help in understanding various options and select the ones which would meet your requirements. 

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