The last two years have made the importance of our health protection clearer than ever. These years have drawn attention to the fact that illnesses, accidents, natural disasters, and other unforeseen circumstances can occur at any time without warning. And in situations where we face these unforeseen circumstances, it can affect not only our mental health but also our financial well-being.
This April, as we celebrate World Health Day, it is important to draw attention to how we can protect ourselves from financial stress related to any illness or emergency through health insurance.
Extensive and adequate health insurance can cover a wide range of costs before and after hospitalization, ambulance charges, costs related to serious illness and other costs depending on the plan chosen. The most important part of any insurance policy for any customer is the claim process when needed. Therefore, understanding the claims process is as important as buying an insurance cover. Being informed can help make the claims process smooth and stress-free.
For a hassle-free claim settlement, a basic understanding of policy is usually helpful.
Here’s a quick checklist of things to keep in mind during the claim process:
1. It is important that you notify your insurer / employer TPA after a medical emergency. In case of planned hospital admission, advance information for cashless plan can be given.
2. Information can be provided through phone, e-mail, SMS, apps and other platforms provided by Insurer / TPA.
3. After being notified, you will receive a claim number. This is an important link for submitting / following your claim in the future
4. It is important to complete the claim form completely with the correct information. You must provide all relevant information requested in the form. All necessary support information should be provided
5. All original copies of receipts and bills should be submitted and a copy of the claim form and receipts should be kept for record.
6. Ensure that all medical investigation reports and consultation papers have been originally submitted. Insurers may be asked to return documents if you need long-term / recurrent treatment
7. Always follow the claims procedure mentioned in the policy document
8. Claim forms and documents must be submitted to the appropriate entity. If the policy is serviced through them, it should be submitted to the TPA, or directly to the insurer for providing the service. In many cases, insurance agents / brokers help collect and submit documents
9. Most insurers ask for proof of identity, KYC documents and account details (including bank / ISFC code) to facilitate remittance of claims. In some cases, a copy of the cancellation check is also required.
Things to avoid:
1. Delay in making a claim
2. Provide incorrect, incomplete or misleading information in the claim form
3. Submission of claim form through a third party not recognized by the insurer
4. Leave important parts of the form blank
With a little foresight and planning, claiming a health insurance can be easy and effortless. Following the steps above can help ensure that the insurer processes the claim quickly, resulting in faster payments if you need it most.
