Health Insurance Claim
Request a reimbursement or opt for cashless compensation.
A health insurance claim is filed by the insurance holder in order to receive the compensation against the amount he/she had paid for the health insurance policy. The claim can be made in two ways – by requesting reimbursement or requesting for cashless treatment in the network hospitals.
Types of Health Insurance Claims
As the health insurance claim is aroused at the time of healthcare emergencies, the claim settlement process must be quick and hassle free. Based on the users needs, the insurers offer two types of health insurance claims.
Cashless Claim
Cashless claim enables the insurance holder to avail cashless treatment at the insurer’s network hospitals where the insurer pays the expenses to the hospital directly.
Reimbursement Claim
Reimbursement claim allows the insurance holder to avail reimbursement from the insurer against the bills he/she had paid for the hospitalization expenses.
Claim Settlement Procedure
Cashless Claim Process
- Inform the insurance provider of the hospitalization requirement as soon as possible.
- On the day of admission to the hospital, display the health insurance ID card of the insured for identification.
- The identity of the insured has to be verified by the hospital.
- After that, a pre-authorization form will be submitted to the health insurer.
- The insurance provider will review all the submitted documents and process the claim accordingly.
- Soon after the discharge, the bills are forwarded to the insurance provider by the hospital.
- The insurers scrutinize the bills and settle the payment with the hospital directly as per the terms and conditions of the policy.
Planned Hospitalization
For a pre-planned treatment, you should inform the insurance providers a few days before the scheduled hospitalization. You can contact them via their toll-free customer care number along with sending a pre-authorization form filled by the hospital.
Emergency Hospitalization
In case of emergency medical treatment, the policyholder himself or his family members should contact the insurance provider to inform them about the person’s immediate need of hospitalization. And also, they must submit a duly filled pre-authorization form within 24 hours.
Reimbursement Claims
- Inform the insurance provider of the hospitalization requirement as soon as possible.
- On the day of admission to the hospital, display the health insurance ID card of the insured for identification.
- The identity of the insured has to be verified by the hospital.
- After that, a pre-authorization form will be submitted to the health insurer.
- The insurance provider will review all the submitted documents and process the claim accordingly.
- Soon after the discharge, the bills are forwarded to the insurance provider by the hospital.
- The insurers scrutinize the bills and settle the payment with the hospital directly as per the terms and conditions of the policy.
Documents
The following documents are required to file a health insurance claim:
