Term insurance ka main purpose family ko financial security dena hai,Term insurance aapke parivaar ke liye ek financial shield ki tarah hota hai.lekin agar claim reject ho jaye toh yahi shield fail ho jata hai.Aaiye samajhte hain 7 asli karan jo India mein term insurance claim rejection ke liye zimmedar hain taaki aap in galtiyon se bach sako
Table of Contents
1.Health/Medical History Chhupana (Non-Disclosure of Medical Information):
Sabse bada reason yehi hota hai.
- Smoking / drinking history
- Diabetes, BP, heart issue
- Pichhle hospitalizations
Sabse common reason hai apni medical history, jaise diabetes, BP, heart disease, ya koi purani beemari, ko chhupana . Agar policy lene ke waqt aapne koi serious bimari nahi batayi aur baad mein death usi se hoti hai, to company claim reject kar sakti hai .
Agar Term insurance proposal form me sahi information nahi di, to company investigation me pakad sakti hai aur claim reject ho sakta hai.
Tip: Term insurance Proposal form khud bharo, agent par fully depend na rahein.
2.Jhoothi ya Adhoori Jankari Dena (Incorrect or Incomplete Information):
Application form mein age, income, profession galat bharna . Kuch log intentionally income kam ya zyada likhte hain jisse premium kam ho, lekin yeh bada risk hai . Galat jankari dene par bhi Term Insurance claim reject ho jata hai .
Agar income exaggerate ki ya risky job (mining, aviation, etc.) disclose nahi ki, to material misrepresentation maana ja sakta hai.
Result:Term Insurance Claim dispute ya reject.
3.Policy Exclusions Ke Under Death (Death Due to Excluded Activities):
Har policy mein kuch exclusions hote hain jaise – policy ke pehle saal mein suicide , adventurous activities (paragliding, scuba diving) , sharab ya nashe ki over-dose se death , criminal activity me death . Agar death inme se kisi karan se hui to claim reject ho jayega.
Most policies me pehle 12 mahine (kabhi 24) ke andar suicide par full payout nahi milta (terms policy par depend karta hai).
Policy document me clause clearly hota hai—ise zaroor padhein.
4.Policy Lapse Hona (Policy Lapse Due to Non-Payment):
Agar premium time par nahi bhare gaye aur policy lapse ho gayi, to us dauran koi claim nahi milega . Grace period ke baad bhi agar payment nahi kiya to policy be-kaar ho jati hai .
Grace period ke baad premium unpaid raha to policy lapse ho sakti hai.
Lapse state me death ho jaye to claim issue ho sakta hai.
Tip: Auto-debit / reminder set karein.
5.Nominee Details Update Na Karna (Nominee Information Not Updated)/Fraud / Fake Documents:
Shaadi, divorce, ya nominee ke death ke baad bhi agar details update nahi kiye to claim process mein rukawat aati hai . Sahi nominee nahi hoga to insurance company legal heirs ko dhundhne mein uljhegi aur claim reject bhi ho sakta hai .
Fake medical reports, forged signatures, ya identity mismatch—ye sab serious violations hain.
Result: Direct rejection + legal action.
6.Claim File Karne me Deri (Delay in Filing the Claim)/Waiting Period / Specific Exclusions:
Policyholder ki death ke turant baad insurer ko inform karna zaroori hai. Deri karne par company claim reject kar sakti hai kyunki investigation mushkil ho jata hai .
Kuch riders ya specific conditions me waiting period hota hai.
Agar death excluded cause se hui (policy wording me diya hota hai), to claim reject ho sakta hai.
Tip: Exclusions section dhyan se padhein.
7.Previous Policies Chhupana (Not Disclosing Past/Existing Policies)/Nominee /Documentation Issues:
Agar aapke paas pehle se koi insurance policy hai aur aapne naye policy lete waqt yeh nahi bataya, to bhi claim reject ho sakta hai . Companies risk assess karne ke liye sab policies ka complete picture chahti hain.
- Nominee details outdated
- Required documents submit na karna
- Bank/ID mismatch
Isse claim delay ya rare cases me dispute ho sakta hai.
Tip: Nominee ko policy details aur documents ki location batakar rakhein.
Claim Rejection Se Kaise Bachein?
- mandari Sabse Best Policy: Application form mein poori imandari se saari jankari bharein, chahe wo medical ho, lifestyle ho ya income .
- Premium Time par Bharein: Auto-debit facility use karein ya reminders set karein .
- Nominee Update Karte Rahein: Har life event ke baad nominee details check aur update karein .
- Policy Documents Padhein: Exclusions ko achhe se samjhein, kya cover hai aur kya nahi .
- Section 45 Ka Dhyan Rakhein: Insurance Act 1938 ke section 45 ke mutabik, policy lene ke 3 saal baad (contestability period) claim sirf fraud ki sthiti mein reject kiya ja sakta hai .
Yeh bhi yaad rakhein ki IRDAI ke mutabik zyadatar companies ka claim settlement ratio (CSR) 95-99% ke beech mein hai . Iska matlab hai ki imandari se policy lene par claim approve hone ke chances bahut high hain.
✔ Proposal form me 100% sach likhein
✔ Medical test skip na karein
✔ Policy document (especially exclusions) padhein
✔ Premium time par bharein
✔ Nominee details updated rakhein
7 Real Reasons Why Term Insurance Claims Get Rejected(IN ENGLISH)
The main purpose of term insurance is to provide financial security to the family. Term insurance acts as a financial shield for your family. However, this shield fails if the claim is rejected. Let us understand the 7 main reasons responsible for term insurance claim rejection in India so that you can avoid these mistakes.
1.Hide Health/Medical History (Non-Disclosure of Medical Information):
This is the biggest reason.
Smoking/drinking history
Diabetes, BP, heart issues
Previous hospitalizations
The most common reason is hiding your medical history, such as diabetes, BP, heart disease, or any other pre-existing illness. If you don’t disclose a serious illness at the time of taking out the policy and later die from it, the company may reject the claim.
If you don’t provide correct information in the proposal form of Term insurance, the company may investigate and the claim may be rejected.
Tip: Fill out the proposal form of Term insurance yourself, have the agent complete it.
2.Providing false or incomplete information (Incorrect or Incomplete Information):
Misrepresenting age, income, and profession on the application form. Some people intentionally understate or overstate their income to reduce the premium, but this poses a significant risk. False information can also result in a Term Insurance claim being rejected.
If income is exaggerated or a risky job (mining, aviation, etc.) is not disclosed, it could be considered a material misrepresentation.
Result: Term Insurance Claim disputed or rejected.
3.Death Due to Excluded Activities:
Every policy has certain exclusions, such as suicide in the first year of the policy, death due to adventurous activities (paragliding, scuba diving), death due to alcohol or drug overdose, and death due to criminal activity. If the death occurs due to any of these reasons, the claim will be rejected.
Most policies do not provide a full payout in case of suicide within the first 12 months (sometimes 24) (terms depend on the policy).
The clause is clearly stated in the policy document—be sure to read it.
4.Policy Lapse Due to Non-Payment:
If premiums are not paid on time and the policy lapses, no claim will be entertained during that period. If payments are not made even after the grace period, the policy becomes void.
If premiums remain unpaid after the grace period, the policy may lapse.
If death occurs during the lapsed state, a claim may be raised.
Tip: Set auto-debit/reminder.
5.Nominee Information Not Updated)/Fraud / Fake Documents:
If details are not updated after marriage, divorce, or the death of the nominee, the claim process gets stalled. If there is no valid nominee, the insurance company will be entangled in finding the legal heirs and the claim may even be rejected.
Fake medical reports, forged signatures, or identity mismatch—these are all serious violations.
Result: Direct rejection + legal action.
6.Delay in Filing the Claim/Waiting Period / Specific Exclusions:
It is essential to inform the insurer immediately after the policyholder’s death. Delays may result in the company rejecting the claim, making investigation difficult.
Some riders or specific conditions have a waiting period.
If the death occurs due to an excluded cause (as specified in the policy wording), the claim may be rejected.
Tip: Read the Exclusions section carefully.
7.Not Disclosing Past/Existing Policies/Nominee /Documentation Issues:
If you already have an insurance policy and don’t disclose it when you take out a new policy, your claim may be rejected. Companies need a complete picture of all policies to assess risk.
Outdated nominee details
Not submitting required documents
Bank/ID mismatch
This can delay the claim or, in rare cases, lead to a dispute.
Tip: Inform the nominee of the policy details and the location of the documents.
How to avoid claim rejection?
Mandari Best Policy: Fill in all the details in the application form with complete honesty, be it medical, lifestyle, or income.
Pay premiums on time: Use the auto-debit facility or set reminders.
Keep nominees updated: Check and update nominee details after every life event.
Read policy documents: Understand the exclusions carefully, what is covered and what is not.
Pay attention to Section 45: According to Section 45 of the Insurance Act 1938, a claim can be rejected only in case of fraud after three years of taking the policy (contestability period).
Also, remember that according to IRDAI, most companies have a claim settlement ratio (CSR) between 95-99%. This means that if you purchase a policy honestly, the chances of your claim being approved are very high.
✔ Write 100% truth in the proposal form
✔ Don’t skip the medical test
✔ Read the policy document (especially the exclusions)
✔ Pay premiums on time
✔ Keep nominee details updated
Final Takeaway
Term Insurance claim zyadatar tab reject hota hai jab information chhupai jaati hai.
Sachchai + proper documentation = smooth claim.