Comprehensive and adequate health insurance can cover pre and post hospitalization expenses, ambulance fare, critical illness expenses and a variety of other expenses depending on the plan chosen. Hence, understanding the claim process is as important as buying insurance cover.
New Delhi . The last year and a half has made the importance of health protection more clear than ever. During this the truth has come to the fore that diseases, accidents, natural calamities and other unwanted situations can come at any time without being informed. And such unforeseen circumstances not only affect us emotionally, but also make us financially weak. We can avoid this financial pressure by protecting ourselves with health insurance. This prevents a health emergency from becoming an economic crisis.
Comprehensive and adequate health insurance can cover pre and post hospitalization expenses, ambulance fare, critical illness expenses and a variety of other expenses depending on the plan chosen. Claim processing is the most important part of an insurance policy for any customer when the need arises. Hence, understanding the claim process is as important as buying insurance cover. Having knowledge can help make the claim process hassle-free and stress-free.
A basic understanding of the policy is generally helpful for hassle-free claim settlement. Below is a list of some of the things that should be taken care of during the claim process:
Do not make any mistake in these things:
1 – In case of medical emergency, it is necessary to inform your insurance company / appointed TPA. If hospitalization is already planned, advance notice can be given for the scheme of cashless treatment.
2- Information can be given on phone number, email, SMS, Apps and other platforms provided by the Insurance Company/TPA.
3- After giving the information, you will get a claim number (Claim Number). This is an important link for you to submit your claim/enquiry in future.
4- It is necessary to fill the claim form completely with correct information. You are required to state all the relevant facts asked in the form. All necessary supporting information should be provided.
5- Original copy of all receipts and bills should be submitted. A copy of the claim form and receipts should be kept for your records.
6- Make sure to submit the original copy of all medical examination reports, counseling related papers. If you need these papers for long term/recurring treatments, the insurer can be requested to return them.
7- It is necessary to always follow the claim procedure as mentioned in the policy documents.
8- Claim form and documents should be submitted at the right place. If the policy is being serviced through TPA, then submit the documents to the TPA, otherwise in case of direct service, submit it to the concerned office of the insurance company. In many cases insurance agents/brokers help in collection and submission of documents.
9 – Most of the insurance companies ask for proof of identity, KYC documents and bank account details (Bank Name/ISF Code) for ease of remittance of claim amount. In some cases a canceled cheque is also asked for.
Avoid these things:
Delay in reporting claim.
Providing wrong, incomplete and misleading information in the claim form.
Submission of claim forms through a third party that is not recognized by the insurance company
Leaving important sections of the claim form blank.
With a little foresight and planning, making a health insurance claim can become simple and easy. Following the above steps can definitely help the insurer in getting the claim processed quickly. As a result, you get early payments in times of need.
