What makes a claim payable or not payable?

Some insurance claims may not be recognized by the insurance company for any number of reasons. If a claimant’s premiums have not been paid in full, the policy itself may not be active.

Another reason that a claim may be rejected is a failure to fall under covered conditions.

Most insurance policies spell out specific areas which qualify for benefits. The areas that do not qualify for benefits are called exclusions. Exclusions are indicated in the policy documents and a claim made on exclusions is not payable.

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