Many people want to buy health insurance to prepare for future medical expenses, but unexpectedly get rejected by insurance companies, especially those with pre-existing conditions or a history of serious illnesses.
The question is: Why do insurance companies reject health insurance applications? And if you are rejected, are there still other options available?
Today, Hugs Guru will help explain the common reasons behind health insurance rejection and introduce alternative coverage options that may still help reduce financial risks, even if you cannot buy regular health insurance.
Why Do Insurance Companies Reject Health Insurance Applications?
When considering a health insurance application, insurance companies mainly assess the applicant’s health risk. If the applicant has a high chance of making future claims, the company may need to bear significant medical expenses.
Common reasons for rejection include the following:
1. Having a Pre-existing Condition or History of Serious Illness
If you have previously been diagnosed with or are currently receiving treatment for certain conditions, such as:
- Heart disease
- Diabetes
- Kidney disease
- Liver cirrhosis
- Stroke
- Depression
- HIV
The insurance company may reject the application or accept it with additional conditions, as these are considered higher-risk cases with a greater chance of future claims.
2. Age Exceeds the Company’s Acceptance Criteria
Each health insurance plan has different entry age limits, such as:
- 15 days to 60 years old
- 1 month to 70 years old
If the applicant’s age exceeds the plan’s limit, the application may be rejected because health risks generally increase with age.
3. BMI Is Too High or Too Low
Many people may not realize that body weight can also affect insurance underwriting.
A high BMI may indicate higher risks of obesity, high blood pressure, diabetes, or heart disease. On the other hand, a very low BMI may be linked to malnutrition or certain chronic illnesses.
As a result, the insurance company may:
- Reject the application
- Increase the premium
- Request additional medical documents or health checkups
4. Incomplete Health Disclosure or Concealing Medical Information
One major reason many people run into problems is not fully disclosing their health history.
Examples include:
- Not declaring pre-existing conditions
- Not declaring past surgeries
- Not declaring previous treatments
Even if the policy is approved, if the insurance company later discovers incomplete or false information, it may reject future claims or cancel the policy retroactively.
5. Frequent Claim History
If an applicant has a history of making many insurance claims in the past, the insurance company may view them as a high-risk applicant. This may also increase the chance of being rejected.
What Can You Do If Your Health Insurance Application Is Rejected?
If you feel that the decision was unfair or have questions about the insurance company’s underwriting process, you can contact the Office of Insurance Commission (OIC) directly.
Official website: OIC
Hotline: 1186
If You Cannot Buy Health Insurance, What Other Insurance Options Are Available?
Even if you cannot buy regular health insurance, there are still other types of insurance that may help reduce financial risks.
1. Personal Accident Insurance (PA)
Personal Accident Insurance is a popular option for people with pre-existing conditions because, in many cases, it does not require a detailed medical examination.
Key Benefits of PA Insurance
- Covers accidents such as car accidents, falls, or cuts
- Covers medical expenses from accidents
- Provides daily compensation if hospitalized
- Covers death or disability caused by accidents
Who Is It Suitable For?
- People with pre-existing conditions
- Seniors
- People who cannot buy health insurance
- People with a limited budget
Premiums often start from only a few hundred to a few thousand baht per year.
2. Critical Illness Insurance with Lump-Sum Payment
Even if you have certain pre-existing conditions, you may still be able to buy critical illness insurance if you have never been diagnosed with the specific serious illnesses covered under the policy.
For example:
- A person with kidney disease may still be able to buy cancer insurance
- A person with diabetes may still qualify for certain critical illness plans
Key Benefits of Critical Illness Insurance
- Receive a lump-sum payout when diagnosed with a covered illness
- Use the payout for treatment, recovery, or income replacement
- Available as disease-specific plans or multi-disease coverage plans
Common Diseases Covered
- Cancer
- Heart disease
- Stroke
- Alzheimer’s disease
- Parkinson’s disease
Premiums may also start from a few hundred to a few thousand baht per year, depending on the plan.
How Can You Increase Your Chance of Getting Health Insurance Approved?
Apply While You Are Still Healthy
The younger and healthier you are, the higher your chance of approval.
Disclose Your Health Information Honestly
Providing complete and accurate health information helps reduce claim problems in the future.
Compare Plans from Multiple Insurance Companies
Each insurance company has different underwriting criteria. One company may reject an application, while another may still consider accepting it.
Let a Broker Help You Plan
A broker can help recommend plans that better match your health condition, budget, and coverage needs.
Some Coverage Is Better Than No Coverage
Some people may not be able to buy regular health insurance due to pre-existing conditions, age limits, or medical history that insurance companies consider high risk.
However, there are still other options, such as Personal Accident Insurance or Critical Illness Insurance, that can help reduce financial burdens when unexpected events occur.
In the end, having some level of protection is often better than having none at all — especially when facing large medical expenses without warning.