How Does the E-Claim Process Work for Group Health Insurance?

The insured is required to submit the original documents along with the claim form to the insurer to settle the claim. The policyholder is expected to send such documents via courier. However, such services were put on halt due to the advent of the Covid-19 pandemic. The pandemic hit the world which urged the government to impose lockdown. Such steps of the government gave rise to e-claim process under group health insurance.

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E-Claim under Group Health Insurance

Due to the lockdown, the courier services were not operational. Hence, the policyholder was not able to send the original documents to the insurer. At the time, several insured wished to settle their claim. Therefore, the insurance company was compelled to come to a conclusion in order to avoid such issues faced by people.

The insurance provider found a solution and gave recognition to e-claim process under group health insurance. The companies took this decision quickly in order to provide ease and relief to the public. As a result, the self-service e-claims came into force in order to help the policyholder to submit their documents via electronic means. Further, e-claim process under group health insurance enables the user to track the record of their claim until settled by the insurance companies.

Group Mediclaim Process

The users under the e-claim process are required to upload scanned documents or images on the e-claim module of the insurance companies. They are required to submit the following documents in order to file the claim.

  1. Claim Form

    The claim form comprises two parts. The insured may download the form from the official website of the insurance company. He may fill in both parts and scan them in order to upload them.

  2. Discharge Summary

    The hospital provides a discharge summary to the patient which includes important information about the disease. The insured must scan the document in order to upload and file the claim. 

  3. Hospital Bill

    The hospital provides a detailed bill to the insured. It comprises all the expenses incurred by the patient in order to obtain the treatment. The insured must scan the hospital bill and upload it to the e-claim module.

  4. Payment of Receipts

    The insured must produce the payment of receipts incurred in the hospitalisation. 

  5. Medicine Prescriptions

    The insured must provide the details of the medicine he was prescribed by the doctors. 

  6. Laboratory Test Reports

    In case of a laboratory test, he must produce the result of the reports to the insurance company.

  7. Copy of Invoice

    In the case of implants, the insured must share a copy of the invoice for such implants.

  8. ID Proof

    The insured is required to provide his ID proof to the insurance company. 

  9. Cancelled Cheque

    The cancelled cheque or the NEFT details is required to provide in order to receive the payment.

Benefits of E-Claim Process under Group Health Insurance

The hassle-free process highlighted the following benefits to the insurer and the insured. 

  1. Processing Time

    The processing time of the claim was reduced. Earlier, the policyholders were required to send the document via courier. However, the e-claim process enables them to scan the document and send it directly to the insurance company. Hence, it reduced the processing time and made the settlement claim easy. 

  2. Track Status

    With the advent of the e-claim process, the policyholder can check the status of the claim they have submitted. The status of the claim is available 24 hours. Therefore, they may check it at their convenience. 

  3. Accuracy

    The e-claim process increases the accuracy of group insurance schemes claim. This resulted in a reduction in the rejection of claims by the insurance company. This led to a reduction in lawsuits.

Conclusion

With the advent of e claim under group insurance, it becomes convenient for companies to keep a record of the claims and data of users. In addition, it simplified the whole process and reduced the overhead cost and time of the insurer and insured.

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Policybazaar for Business - Group Health Insurance - Customer Reviews
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4.4/5
Based on 189 reviews
4.4
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Based on 189 reviews
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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.
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