How to Claim Health Insurance - A Step-by-Step Guide

When you are filing a claim for health insurance, you need to remember certain things to make sure you do not face any rejection from the insurance company.

Steps to Claim Your Health Insurance.

• Pre-Inform:

  Inform your insurance company, in case of a planned hospitalization, before you are admitted to the hospital; for emergency hospitalization, you have 24-hours to do the needful

• Documents:

  Provide hospital documents to the insurer while submitting the claim; collect receipts, prescriptions, discharge papers, and copies of report before leaving the hospital

• Follow Procedures:

  Make sure to follow the procedures accurately when filling the claim form available on your insurer’s website; ensure that the hospital and doctors fill the required parts carefully

• Insurance Papers:

  Check the insurance papers carefully to make sure that your bank details are correctly updated to avoid unnecessary delays

• Submission:

  Make sure to submit the form along with the required documents at the earliest after being released from the hospital

• Additional Requirement:

  It might take up to 45days for the claim to be completed. During this time, the insurance company can ask for additional documents

Cashless Claim vs. Reimbursement Claim

Cashless Claim

Cashless health insurance claim option offers you the facility of being admitted in a network hospital, which has a tie-up with your insurer, that too without paying from your pocket. You need to provide the insurance documents to the hospital during admission to avail of the facility. The hospital will send the bills directly to the insurance company. In case the hospitalization is planned, you must contact the insurer before the admission to process the claim.

Reimbursement Claim

If you are treated in a hospital, which is not affiliated with your policy provider, you cannot avail the cashless treatment. You have to pay the hospital bills with your own money and then make a reimbursement claim. You need to submit the hospital documents, which include bills, prescriptions, reports, and the other required papers to the insurance company to file a claim. The insurer will then process your claim and reimburse you if the claim is accepted.

Requirements for Initiating the Insurance Claim

You need to meet certain requirements while filing a claim for your medical insurance policy plan. Listed below are the mandatory requirements:

• Policy number

• Health insurance card

• Personal information of the policyholder

• Address and contact information of the policyholder

• The reason for the required medical care

• Address and the personal information of the doctor or the medical care provider

• Information regarding the hospital where the policyholder is admitted

• Date of admission

Things to Remember When Filing a Health Insurance Claim

You need to keep these points in mind while filing a claim:

• Make the claim immediately

• Remember that there is a 30-45 day waiting period after making a claim in case of reimbursement

• Note that charges regarding telephone calls, laundry services, and visitor’s pass are not usually covered in the policy

• Contact the insurer’s helpline number and inform them about the situation

During emergencies, the online health insurance claim process can save a lot of time. You can initiate the claim from anywhere if you have access to the Internet.