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If an insured fails to intimate the insurer about hospitalization within the stipulated time, what is the likely consequence under the health insurance claim settlement process?

medium Q15 of Q15
Insurance Awareness - Health Insurance
If an insured fails to intimate the insurer about hospitalization within the stipulated time, what is the likely consequence under the health insurance claim settlement process?
AClaim will be automatically approved
BInsurer will pay double the claim amount
CClaim may be rejected or delayed
DNo impact on claim settlement
Step-by-Step Solution
  1. Step 1: Understand importance of intimation

    Timely intimation is mandatory to allow insurer to verify and process the claim efficiently.
  2. Step 2: Consequence of delay

    Failure to intimate within the stipulated time may lead to claim rejection or delay as per policy terms and IRDAI guidelines.
  3. Final Answer:

    Claim may be rejected or delayed → Option C
  4. Quick Check:

    Insurers require prompt intimation to avoid fraud and process claims smoothly.
Quick Trick: Always intimate insurer within 24-48 hours of hospitalization.
Common Mistakes:
MISTAKES
  • Assuming late intimation has no effect on claim settlement.
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