A short-settled claim is a claim where the approved payout is less than the amount originally claimed, based on policy terms, coverage limits, or claim assessment.

Claims may be short-settled due to reasons such as:

• Policy exclusions or sub-limits

• Deductibles or co-pay clauses

• Non-covered expenses

• Depreciation or admissible limits

• Incomplete or incorrect documentation

• Excess amount beyond sum insured

You can review:

• The claim settlement letter/email

• The claim summary or explanation of benefits (EOB)

• Your policy document for applicable terms

Yes. A detailed settlement statement is provided showing:

• Claimed amount

• Admissible amount

• Deductions (with reasons)

• Final payable amount

Yes. If you believe the settlement is incorrect, you may:

• Raise a claim re-evaluation request

• Submit additional supporting documents

• Contact customer support within the defined timeline

Yes. Disputes must usually be raised within 15–30 days from the settlement date (as per policy or company guidelines).

Depending on the case, you may be asked for:

• Additional bills or invoices

• Medical reports or prescriptions

• Clarification letters from providers

• Policy endorsements or approvals

If the review confirms eligibility, the settlement amount may be revised. Otherwise, the original settlement will remain unchanged.

No. A short-settled claim does not negatively impact future claims, provided they are valid and within policy coverage.

You can reduce the chances by:

• Understanding your policy coverage and limits

• Submitting complete and accurate documents

• Choosing network providers (if applicable)

• Confirming coverage before availing services