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Claiming Health Insurance

01. Documents Required to have a smooth Claim Process

Most of us feel secure when we buy a health insurance policy as it protects us against unforeseen events. But, we only value a health insurance policy when making a claim. There can be situations when the claim can be rejected, maybe when the health insurance policy has lapsed, in case of non-payment of the insurance premium, and so on.

A health insurance claim is a process in which the policyholder requests the insurer to get the benefits of a health insurance plan in case of medical exigency. This process can be done either by cashless treatment or reimbursement. There is a procedure to file a claim. If you are well informed about the health insurance claim process, it is not a hassle. All you need to do is to inform your hospitalization customer support team within a specified timeframe along with the required documents.

Care Health Insurance has a convenient claim settlement process. The process can even be done online by visiting our company’s official website. We have vast cashless healthcare providers of more than 21,100+ where we have successfully settled 95.2% of insurance claims. We offer a simple and quick claim procedure.

In this article, we will tell you documents required for health insurance claim if you have a health insurance policy from Care Health Insurance.

02. Documents Required for Making Health Insurance Claim:

Mentioned below is the list of documents that are required to make the health insurance claim process for reimbursement claim:

  • Duly completed original claim form along with your signature
  • Valid identity proof
  • Doctor’s prescription recommending hospitalization
  • Doctor’s prescription advising medicines, diagnostic tests, and consultation
  • Original pharmacy bills
  • First Information Report(FIR), if applicable
  • Policy details that include the name of the insured, policy number, illness, and address
  • Indoor case papers
  • Ambulance receipt
  • Any other document required to assess the claim, in case of any fraud

Other documents required for a cashless facility

  • Submit the pre-authorization form.
  • Valid identity proof along with your photograph.
  • Documents such as voter identity card, PAN card, Aadhar card, and driving license.

The claim form and the documents should be sent to our claim management team.

03. Claim Process for Cashless Treatment:

You can get a cashless facility at more than 21,100+ cashless healthcare providers across the country. Find a network hospital where you can avail of cashless health insurance treatment. You need to follow the following steps:

  • Get the pre-authorization form available at the hospital’s insurance / TPA Desk.
  • Send it to the customer support team.
  • You will get an approval letter after verification.
  • For further any query from the claim management team, you or the hospital staff must respond to it.
  • You can carry on your treatment as per the doctor’s advice and file for a reimbursement claim a cashless request gets rejected.
  • Claim Process for Mediclaim Reimbursement Process.

In case of an emergency, the policyholders have to bear the medical expenses from their own pockets. But they can file for reimbursement right after the discharge. This facility is helpful when an individual gets treatment at a non-network hospital.

You need to abide by the following steps:

  • Submit a claim form along with the required documents, as per the policy terms & conditions
  • You will receive an approval letter sent by the claim management team
  • Insured to respond to the query raised by the claim management team
  • The team will communicate the reason in case of rejection

Conclusion

The insured should not delay in claiming any delay in the intimation and may reject the claim.

Make sure that all the facts are handy in chronological order and that the information provided is correct. Also, keep your policy details and personal details handy with you. All the documents should be handy, as the absence of any document may cause a delay in the claim process.

It is crucial to follow the guidelines mentioned in your health insurance policy to be sure that your money does not go waste.