Increasing Claim Rejections

We are buying the health insurance thinking that it will help us to not spend much when in medical emergencies. Now the problem is a lot of claims are getting rejected. I know a lot of people try to extract money from insurance companies with the help of hospitals but still instead of rejecting the false claims, they are rejecting the genuine claims too.

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Recently I read somewhere that a lady got admitted in the hospital because the doctor advised since she was having a high fever. Now after 2 days she got discharged. After that she started the claim from the insurance companies, but it got rejected. They rejected because they thought that the hospitalization is not necessary. Now the thing is who is correct, the doctor who said that the hospitalization is required or the insurance guy who thought the hospitalization is not required.

To be honest if the doctor is advising us to do something, we have to do because they know better. Now the insurance guy is not present at the time of hospitalization, they didn't knew the condition you are in, so rejecting the claim doesn't make sense. A lot of hospitals also does shady things. For them taking money from the patients is the ultimate goal. And that's why they make the patients and their family fearful and thus eventually they fell into the trap and get admitted.

So yeah in both thr ways you are the ultimate loser. You will lose money because of hospitalization which is not necessary because then the insurance will not pay for that. And that's why we also have to be little vigilant. We should take 2nd opinions before getting hospitalized. I know the time might not be there much in case of emergencies. But if the emergency is not there, getting the 2nd opinion is always better. And again always go with the cashless hospitalization, because through that getting the claim rejected is not an option itself.