Insurance Claim Rejected Due to Policy Exclusion? Know Your Legal Options in India Has your insurance claim been rejected because the insurer says that the loss or treatment falls under a policy exclusion ? A rejection letter does not necessarily end the matter. The policy wording, circumstances of the claim, documents submitted and the insurer’s specific reason for repudiation need to be examined carefully. First, check the exact exclusion relied upon Ask for and carefully examine the repudiation/rejection letter and the precise clause cited by the insurer. An exclusion should be considered in the context of the complete policy terms, including definitions, conditions, endorsements and coverage provisions. The Supreme Court has reiterated that insurance contracts are generally construed according to their terms and that exclusion clauses are interpreted strictly. It has also recognised that the insurer bears the burden of establishing the applicability of an exclusionary cl...
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