How to File a Health Insurance Claim?
Health Insurance

How to File a Health Insurance Claim?

Health insurance provides you a safety net against unforeseen medical emergencies. A health insurance plan is the best way to ensure that you get quality medical care when you need it the most.

How to process medical insurance claims?

It is essential to know how to claim health insurance. If the policyholder does not get to enjoy the insurance benefits, then the health insurance plan is of little use. If you wish to know how to claim medical insurance, here is a step-by-step guide.

  • Inform the insurance company before hospitalisationor within 24 hours of admission. This is important if you want to process the claim for health insurance seamlessly. .

  • Keep a record of all the relevant hospital documents when you fill up the claim form and ask for the claim amount. You will need to attach copies of these documents along with the claim form. The documents include various receipts collected from the hospital, discharge summary, reports of various procedures conducted and prescriptions from doctors. .

  • Provide correct details in your claim form. Do not leave any relevant portion unfilled as that may directly impact the success of your insurance claim. .

  • Sign and submit the form to the health insurance company as soon as possible. .

  • Be prepared to provide additional documents, if needed.

Note that the above-mentioned claim process is not applicable on cashless claims.

How to claim for health insurance with a cashless policy?

If you are wondering how to claim for medical insurance when you have a cashless policy, here’s all that you need to know:

  • For cashless policies, the insurance company will provide you with a list of hospitals that come within its network.

  • If you get admitted to any of the hospitals mentioned in the list, then you do not need to pay anything from your pocket.

  • Do provide the relevant policy documents in the hospital at the time of admission.

  • The hospital bills will be sent to your insurance company directly.

  • Once the insurance company is satisfied with the claim, it will make the payment.

How to claim Mediclaim?

You want to know how to claim Mediclaim insurance? Here are the details.

  • Start by getting all the relevant medical documents in order.

  • Fill in the required details in the claim form and double-check to ensure that you have entered the correct details. Also, check that the policyholder has signed the claim form.

  • Ask the health insurance company for details of the Third-Party Administrator (TPA) who will be processing the Mediclaim. Carry the original and photocopies of all the medical documents when you visit the TPA.

  • A representative of the TPA will collect the form from you and check if all the details/documents are in order.

  • Inform the insurance company that you have submitted the claim form to the TPA.

How to claim health insurance benefits from two policies?

It is not uncommon for a policyholder to have two medical insurance policies. This is usually done to get better coverage. It is also possible to claim the benefits from two policies at the same time.

While the procedure for filling up the form and submitting the relevant documents to the insurance company remains the same as above, keep in mind the contribution clause if you have multiple insurance policies.

A contribution clause means that when a claim is raised under two insurance policies, each insurance company will contribute an amount equivalent to the ratio of the assured sum. In case your claim amount exceeds the sum insured, the contribution clause will apply. However, if it is less than the assured sum, the clause won’t kick in.

Choosing the appropriate medical insurance policy is the best way to handle your medical bills. So, based on the requirements and medical history, select a health insurance policy that will ensure access to better health care for you and your loved ones.

Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.

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