The biggest reason for buying health insurance is to get financial support during a medical emergency. For that, you need to either file a cashless or reimbursement claim with your insurance provider. Since cashless claims are possible only at your insurer’s network hospitals, you must raise a reimbursement claim for treatments obtained at other hospitals. Read on to know everything about reimbursement claims.
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply
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You can file a reimbursement claim under your health insurance policy under the following circumstances:
Follow the steps given below to file a reimbursement claim under your health insurance policy:
The first thing is to inform your insurance company or TPA about your emergency or planned hospitalization. In case you plan to get hospitalized for treatment, you must inform your insurer or TPA at least 48 hours before admission. On the other hand, if you have been admitted to a hospital due to a medical emergency, intimate your insurer or TPA within 24 hours.
Once you have informed your insurer, simply obtain treatment at the hospital and focus completely on getting cured.
At the time of getting discharged from the hospital, make sure to pay the entire hospital bill in full.
Make sure to obtain all the medical documents related to your treatment at the time of getting discharged from the hospital, including the hospital bills and discharge summary.
Once you have been discharged from the hospital, fill up the health insurance claim form of your insurance company. The form can be easily found on the website of the insurance company.
You should submit all the required documents to your insurance company within the stipulated time frame (usually 15-30 days). You can check your policy documents or contact your insurer to know the exact list of documents required.
The insurance company will verify all the documents received and cross-check with the coverage available under your health insurance policy. Once the documents have been verified, your claim will be either accepted or rejected within 30 days of receiving the documents. If the insurer requires more documents, they will let you know.
If your claim has been accepted, the insurance company will pay you the claim amount.
Here is a list of documents that you may need to submit while filing a reimbursement claim under your health insurance policy:
Check out a few things that you should keep in mind while filing a health insurance reimbursement claim:
Filing a claim is the first step to obtaining financial assistance from your insurance company at the time of a medical emergency. If you cannot file a cashless claim, a reimbursement claim is the best option for you. Make sure to carefully go through the steps involved in filing a reimbursement claim so that you make no mistakes. Also, keep the above-mentioned things in mind while filing a reimbursement claim under your health insurance policy.