Insurer rejected friend's claim - got paid in 6 weeks, here's how

[Usha]

His dad had a heart procedure. Insurer rejected it saying it was a pre‑existing condition.

Standard rejection letter. Vague reason. Most people just give up here.

We didn't. Three things made the difference:

1. We got the rejection reason in writing. Insurers often give vague verbal reasons hoping you won't push. As soon as you ask for a written rejection with the exact clause they're citing, the tone changes.

2. We checked the diagnosis date. The condition they mentioned was diagnosed after the policy started. They were factually wrong. This happens more often than you think; insurers bet on you not checking.

3. We went straight to the grievance cell. Not the usual customer‑care number, but the insurer's internal grievance officer. We wrote a formal letter quoting the exact policy clause and attached the doctor's note confirming the diagnosis date. Clean, specific, documented.

We settled in six weeks.

The system is designed to make you give up at step one.

If your claim was rejected and something feels off, it probably is. Happy to answer any questions.

[Amar]

I'm glad for you, but the point is the insurer just didn't do what they were supposed to. There's no penalty for a wrong denial.

[Aftab]

Bro, if you're getting insurance, do we have to do a full health check ourselves and send those reports to the insurer for reference?