When your health insurance claim is rejected for “non-disclosure”: What to do next

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• Insurers may reject claims for "non-disclosure" of material health details
• Ask for a detailed repudiation letter to clarify the insurer's specific allegation.
• Organize documents and timelines to support your case in non-disclosure disputes

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A health insurance rejection is stressful in any situation, but “non-disclosure” lands differently because it sounds like the insurer is saying you hid something. Sometimes that is what they mean. In many cases, though, it is less dramatic and more procedural: an old medical note gets interpreted as a pre-existing disease, a hospital admission form uses loose wording, or the insurer believes a past condition was relevant and should have been declared when you bought the policy. The outcome often depends on how clearly you can show what you knew at the time, what you disclosed, and what the medical record actually says.

What insurers typically mean by “non-disclosure”

Insurers use the term when they believe a material health detail was not declared in the proposal form or renewal declaration. “Material” is important, because the insurer is essentially arguing that if they had known this information, they would have priced the policy differently, applied an exclusion, imposed a waiting period, or declined the risk. In practice, disputes arise because policyholders often disclose what they remember and what they have been formally diagnosed with, while insurers may treat symptoms, incidental findings, or loosely described history as proof of an older condition.

Start by asking for specificity, in writing

If the rejection message is vague, your first move should be to ask for a detailed written repudiation letter that clearly states what the insurer says was not disclosed, which documents they are relying on, and how they are linking that alleged non-disclosure to your current claim. This is not a formality; it is the foundation of your response, because you cannot rebut a generic allegation effectively. A good repudiation letter will usually cite a line from the discharge summary, admission notes, or past records, and it may refer to the specific question in the proposal form that they believe was answered incorrectly.

Re-check the proposal form the way the insurer will read it

Once you know what they are pointing to, pull out the proposal form and read the exact question that relates to the alleged non-disclosure. Many consumers remember the spirit of what they answered, but disputes are decided on the literal wording. If the question asked about “diagnosed diseases” or “treatment in the last X years,” that is different from a blanket “any illness ever,” and it matters when you argue that you disclosed what you reasonably knew at the time. If the condition was undiagnosed, never communicated, or never treated before you bought the policy, you will want to build your case around that timeline.

Build a clean timeline, because timelines win these disputes

Non-disclosure arguments become much easier to evaluate when the sequence of events is laid out clearly. Create a one-page timeline that includes the policy start date, the first date of diagnosis (if any), the first documented treatment or medication, and the dates of the current hospitalisation. Then match each milestone to a document that proves it. This approach keeps your grievance focused and reduces the chance that the insurer dismisses your response as “claims without evidence.”

Collect the documents that actually help, not everything you can find

In non-disclosure disputes, certain records tend to be disproportionately useful. The proposal form and policy schedule are essential because they show what you were asked and what you answered. The discharge summary, admission notes, lab reports and imaging reports matter because they show what the hospital recorded and when. Older prescriptions and diagnostic reports can be helpful if they show either that the condition did not exist earlier, or that a past episode resolved and had no continuity of care. If you have annual health checks that show normal readings before policy purchase, those can also be persuasive because they help demonstrate that there was no known ongoing condition at that point.

A short written clarification from the treating doctor can make a real difference, particularly when the insurer is relying on a hospital phrase like “known case of” that may have been entered based on a rushed patient history at admission. Doctors can often clarify whether a condition was newly diagnosed, whether an incidental finding is being over-interpreted, or whether the current admission was unrelated to the alleged past condition. This is not about “fighting the insurer”; it is about making the medical record precise.

Write your response as a case file, not a complaint

When you submit your grievance, aim for a structured, factual note. State what was disclosed at the time of purchase, explain what you did not know (if that is the case), and point to documents that support your timeline. If the insurer is relying on a particular line in the hospital record that you believe is incorrect, you can ask the hospital for a clarification or correction, and attach that as well. The goal is to make it easy for a reviewer to see that the repudiation rests on an assumption that is either unsupported or over-broad.

Escalate step-by-step, because process matters

If the initial grievance response is negative, escalate to the insurer’s grievance redressal officer and keep the full paper trail in one thread. If the insurer still refuses to reconsider and you believe your documentation is strong, the Insurance Ombudsman route is designed for exactly these consumer disputes, and it is often more approachable than people assume. The key is that your file should be complete and organised before you escalate, because the strength of your documentation will carry more weight than the strength of your frustration.

When overturning the rejection is genuinely hard

There are cases where the insurer’s position is difficult to challenge, such as when there is clear proof of long-term treatment before the policy started and the claim is directly linked to that condition. Even then, a disciplined approach can sometimes improve outcomes if you can show that the alleged non-disclosure was not deliberate, that the question in the proposal form was ambiguous, or that the insurer is treating an unrelated historical detail as material. Outcomes vary, but the worst outcome usually comes from giving up early or sending an unstructured response that does not address what the insurer is actually alleging.

The practical lesson, even when you succeed, is that health insurance is unforgiving about disclosures. Over-disclosing feels uncomfortable at purchase time, but it is far easier than fighting a repudiation later when you are least equipped to deal with it.