File Reimbursement Claim under Group Health Insurance

Filing a reimbursement group health insurance claim is an important process that policyholders need to understand in order to receive the benefits they are entitled to. This process can be quite complex. However, following a few simple steps can ensure that a claim is processed quickly and efficiently.

Read more
Tailored health plans, dedicated expertise - the perfect match for your organization's well-being
Customized plans

Affordable prices

24X7 Support

Dedicated claims manager

Total Care

All round wellness benefits

Fast-track your search with instant quotes from prominent insurers
₹1 Lakh cover starting at
₹110/month/employee+
No medical test required
Zero waiting period
Paperless claims
secure-icon We don't spam
Get Updates on WhatsApp

Whom do you want to insure?

  • Employee, spouse & kids

  • Employee only

Reimbursement Claim Process in Group Health Insurance

  • First, it is important to understand what reimbursement claim process in group health insurance. In the context of a group health insurance policy, a reimbursement claim is a request for payment of medical expenses that the policyholder has incurred. These expenses may include doctor visits, hospital stays, prescription drugs, and other medical services. To be reimbursed for these expenses, the policyholder must first submit a claim to their insurance provider.
  • To file the reimbursement claim process in group health insurance, the policyholder should start by collecting all the necessary documents related to the medical expenses. This may include receipts, bills, and other records that provide evidence of the services that were provided and the costs associated with them.
  • Once all the documentation has been gathered, the policyholder should contact their insurance provider to obtain the necessary claim forms. These forms will typically require the policyholder to provide certain information. This includes data, such as medical services that were received, the dates of service, and the costs associated with each service.
  • After completing the claim form, the policyholder should attach all the necessary documents and submit the claim to their insurance provider. The insurance provider will then examine the claim and interpret whether the insured is entitles for reimbursement.
  • If the claim is approved, the policyholder will typically receive a reimbursement check or direct deposit for the amount of the approved expenses. If the claim is denied, the insurance provider will explain the reason for the denial.
  • It is important to note that the reimbursement claim process in group health insurance can take several weeks or even months to complete. This is why it is important for policyholders to keep detailed records of all their medical expenses and to submit their claims as soon as possible.
  • Overall, the reimbursement claim process in group health insurance requires attention to detail and careful follow-through. By providing accurate information and submitting all required documentation, members can increase their chances of a successful claim.

Documents Required

The following documents are required for reimbursement claim process in employer employee insurance.

  1. Claim Form

    The claimant must fill out a claim form, which includes personal information, details of the medical treatment received, and the amount being claimed.

  2. Medical Bills

    The claimant must submit original copies of all medical bills related to the treatment received. These should include the name and address of the provider, the date of service, and a description of the services provided.

  3. Prescription Receipts

    If the treatment involved prescription medications, the claimant must submit original receipts showing the cost of the medication and the date it was purchased.

  4. Doctor's Certificate

    The physician must provide a certificate of diagnosis and treatment. This includes details, such as the date of onset of the illness or injury, the extent of the disability, and the recommended treatment.

  5. Hospital Discharge Summary

    If the claimant was hospitalized, they must submit a copy of the discharge summary. This includes details of the admission and the treatment received.

  6. Other Relevant Documents

    The insurer may request additional documents depending on the nature of the claim, such as laboratory reports or diagnostic imaging results.

Conclusion

Filing a reimbursement claim under group health insurance policy can be a complex process. However, by following the necessary steps and providing all the required documentation, policyholders can ensure that their claims are processed quickly and efficiently. If someone is unsure about how to file a claim or has any questions about your coverage, it is always best to contact the insurance provider for guidance.

calcu-img

Group Health Insurance Premium Calculator

Who do you want to insure?

  • Employees
  • Employees & their family
icon

Minimum lives should be 7

  • 1 Lakh
  • 2 Lakh
  • 3 Lakh
  • 4 Lakh
  • 5 Lakh

Include maternity coverage

Premium starts from

(Excluding GST)

Let's find the right plan for you

Speak to our experts to get the right plan for your company's needs

icon Expert advice made easy icon
  • Date
  • Time

When do you want a call back?

  • Today
  • Tomorrow
  • 25 Jul
  • 26 Jul
  • 27 Jul
  • 28 Jul
  • 29 Jul

What will be the suitable time?

  • 11:00am - 12:00pm
  • 12:00pm - 01:00pm
  • 01:00pm - 02:00pm
  • 02:00pm - 03:00pm
  • 03:00pm - 04:00pm
  • 04:00pm - 05:00pm
  • 05:00pm - 06:00pm

Tell us the number you want us to call on

Your privacy matters. We won't spam you

Call scheduled successfully!

Our experts will reach out to you on 4th June between 2:00 PM - 3:00 PM

Now help your friend get Business Insurance

Your referral is greatly appreciated!

Our team will reach out to your friend soon to help with their business insurance requirements.

Wait! Didn't find what you were looking for?

Our certified business insurance experts are just a call away.

icon Expert advice made easy icon
  • Date
  • Time

When do you want a call back?

  • Today
  • Tomorrow
  • 25 Jul
  • 26 Jul
  • 27 Jul
  • 28 Jul
  • 29 Jul

What will be the suitable time?

  • 11:00am - 12:00pm
  • 12:00pm - 01:00pm
  • 01:00pm - 02:00pm
  • 02:00pm - 03:00pm
  • 03:00pm - 04:00pm
  • 04:00pm - 05:00pm
  • 05:00pm - 06:00pm

Call scheduled successfully!

Our experts will reach out to you on 4th June between 2:00 PM - 3:00 PM

Call scheduled successfully

Thank you
Our experts will provide you assistance with your
insurance coverage. Be assured, all your questions
will be answered

Customizable plans from top insurers

starting @ ₹110/employee*

View Quotes
Group Health Insurance Articles
GIPSA stands for General Insurance Public Sector Association.It is a group of four General insurance companies...Read more
28 Apr 2022 by Policybazaar 16932 Views
A group medical insurance scheme offers many benefits in addition to providing financial support during medical...Read more
08 Feb 2023 by Policybazaar 8790 Views
Companies worldwide strive to attract top talent by offering competitive salaries and outstanding corporate...Read more
15 Sep 2023 by Policybazaar 2641 Views
GPA (Group Personal Accident) and GMC (Group Medical Coverage) are two popular types of insurance policies often...Read more
01 Jun 2023 by Policybazaar 8495 Views
Extended work hours or working on holidays and weekends have become common in workplaces. Compensatory leave for...Read more
18 Apr 2024 by Policybazaar 1108 Views
Investing in Group Health Insurance (GHI) is crucial for...Read more
07 Jun 2024 by Policybazaar 229 Views
Co-pay in group health insurance was Insurers introduced the...Read more
06 Jun 2024 by Policybazaar 238 Views
In today's workplace, companies must foster a culture of support...Read more
31 May 2024 by Policybazaar 281 Views
Extended work hours or working on holidays and weekends have...Read more
18 Apr 2024 by Policybazaar 1108 Views
In today's competitive job market, where top talent holds the...Read more
29 Mar 2024 by Policybazaar 401 Views
Policybazaar for Business - Group Health Insurance - Customer Reviews
View all
4.4/5
Based on 189 reviews
4.4
out of 5
Based on 189 reviews
38 users
136 users
15 users
0 users
0 users
3.8 April 09, 2023
Mansi
Excellent Support
It was easy to buy insurance from PolicyBazaar website and customer support was also amazing to clear all the doubts.Thankyou. Highly worth it.
Dehradun
4.3 April 01, 2023
Mahesh
Necessary Investment
It is a good and necessary investment. Thanks PB.
Lucknow
4.3 March 24, 2023
Surya
Provides Satisfactory Results
I purchased Group health insurance at policybazaar recently and i am so much satisfied with the plan. The application process was smooth and efficient, making the typically tedious task of getting insurance surprisingly hassle-free.Thanks PB.
Bareilly
3.8 March 16, 2023
Naveen
Helpful In Making Decisions
When it came to selcting the right Group Health Insurance, Policybazaar offered an impressive range of options from reputable insurers. I appreciated the comprehensive details avalable for each policy which helped me to take the better decisions. Thankyou.
Delhi
4.3 March 15, 2023
Rajesh
Increases Clients Expectations
I recently had the pleasure of securing a Group Health Insurance policy throug PolicyBazaar and I must say the Entire process exceeded my expectations! From start to finish, their service werw great. Thankyou.
Delhi
3.8 March 02, 2023
Ravi
Great Experience
I got great deals on PolicyBazaar website. Highly recommend.
Pune
4.3 February 17, 2023
Diljeet
Excellent Purchase
It was a excellent purchase at PolicyBazaaar. Thankyou team.
Coimbatore
4.3 February 04, 2023
Satya
Prompt Services
Policybazaar's efficient claims process was impressive. In case of any medical emergencies, my employees were able to get their claims settled swiftly, allowing them to focus on their health and recovery without worrying about financial aspects.Thankyou
Chennai
4.3 January 22, 2023
Abhishek
Budget Friendly Purchase
Thankyou PolicyBazaar for providing such a great plan at affordable premium rates. It was a budget-freindly purchase.
Delhi
4.3 January 09, 2023
Abhash
Multiple Range Of Benefits
I purchased Group health Insurance which offered me plans with affordable rates Thankyou PB.
Pune