Unified UAE Legislation Database

FAQ: The situation is evolving around a car accident. Health insurance rejects a claim citing hidden exclusions or pre-existing health conditions.

Status

In force

Issuing Authority

Effective date

XX.XX.XXXX

Official Link

https://

Answer:

 

Health Insurance Claim Denial (Hidden Exclusions / Pre-existing Conditions)

 

Obtain a copy of your health insurance policy and check еerms regarding pre-existing conditions and clauses labeled as exclusions.

Ask the insurer for a written denial explaining the exact policy clause being invoked.

Obtain a detailed medical report from a licensed UAE doctor or hospital explaining the nature of the injury from the accident. Show that the condition requiring treatment directly resulted from the accident and is not pre-existing.

 

4. File a Complaint with the Insurance Authority

If the insurer refuses to pay, submit a complaint to the Insurance Dispute Resolution Committee (IDRC) (now part of the Banking and Insurance Dispute Resolution Unit (BIDRU) under the Central Bank) and Sanadak (financial and insurance ombudsman unit). 

 

Include policy copy, accident report, denial letter, and medical evidence. The authority reviews disputes and can c...