Paisa Vaisa with Anupam Gupta Why Your Insurance Claim Might Be Rejected (And How to Ensure 100% Payout) | Paisa Vaisa
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Jan 19, 2026 Mayank Bathwal, CEO of Aditya Birla Health Insurance, dives into the complexities of health insurance. He reveals that 15-20% of claims are tied to fraud, which impacts premium costs. Learn why cashless claims are the preferred choice and how personal involvement in your claims process can prevent rejections. Mayank also discusses wellness-linked policies that reward healthy lifestyles with potential premium returns. Plus, hear about the role of technology in evolving health management and the future of health coaching.
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Fraud, Waste And Rising Premiums
- Around 15–20% of claim costs are linked to fraud, waste, or abuse and inflate premiums for honest customers.
- Waste and abuse are harder to detect than outright fraud and require industry-level data and tech to manage.
World Cup Hospital Abuse Example
- During the Ahmedabad World Cup, people reportedly used hospitals as paid accommodation and billed insurers for stays.
- This example illustrates how local events can trigger bizarre abuse of insurance systems.
Personally Complete Your Application
- Fill your own application form and review every question personally to avoid undisclosed issues later.
- Keep a copy and review pre-existing condition listings in the policy document immediately after purchase.
