Home / Articles / Health Insurance / 6 Things to Consider Before Filing Your Health Insurance Claim
Team AckoMay 20, 2022
Like car insurance, health insurance is also meant to provide financial cushioning in case of mishaps. Unlike car insurance, health insurance is not mandatory. As a result, people often perceive it as an expense rather than a precautionary measure. This approach leaves a major part of the population without a health cover. Even, those who have a health insurance cover might not be well-versed with the details regarding raising a claim. Claim settlement is the most crucial aspect of medical health insurance for the policyholder.
Contents
Mr. Suresh was admitted in the hospital as he was severely hurt after falling down from the stairs. Fortunately, he had purchased a dedicated Personal Accident Cover health policy. Being from a modest background, his family felt comforted knowing that there was an insurance policy to take care of the expenses. However, Mr. Suresh and his family were in for a shock as the insurance company refused their claim request because the policy was expired.
You must manage your health insurance actively so that you are covered all the time. An expired policy is considered as an inactive policy and no insurance company will settle a claim request raised in case of an expired policy.
It is common to get confused regarding Mediclaim and health insurance. Some people use Mediclaim and Health Insurance interchangeably. However, there is a difference in coverage when it comes to these policies. Whether it is a Mediclaim policy or a health insurance policy, you must be aware of the coverage and raise a claim accordingly.
Going through the inclusions and exclusions of a health insurance/Mediclaim policy will give you an idea whether the condition against which you plan to raise a claim is covered by your policy or not. If you are not sure, you can get in touch with your insurer to get your doubts clarified.
Merely knowing the inclusions and exclusions isn’t enough. Your claim request won’t be approved if the condition for which you are raising a claim is disqualified as per the terms and conditions of the policy.
If you are going for planned hospitalization and cashless claim settlement, it is suggested to intimate the insurance company seven days prior to hospitalization. In case the policyholder is hospitalized in an emergency situation, such admission must be notified within 24 hours for a smooth claim settlement process.
If the policyholder is admitted in a non-network hospital, then the insurance company shall settle the claim on reimbursement basis. In such cases, the policyholder needs to submit all necessary documents within 7 days of getting discharged from the hospital.
Documentation:
Claim application
Discharge card
Bills
Reports
Prescription details
Ensure proper communication with the insurance company. Almost every claim is different in some ways. There might be certain complications in a case which do not exactly fit well with the existing process of an insurance company. Therefore, two-way communication is extremely important. You can do your part by communicating upfront with the insurance company and being patient regarding their response. Also, answer all their queries truthfully and comply with them regarding the claim settlement process.
Nowadays, it has become extremely easy to purchase, review, renew, compare, and educate yourself regarding health insurance. All this can be done through your smartphone within minutes. Make an informed choice while purchasing the policy and follow the claim settlement process of your insurer for trouble-free claim settlement.
Also, check: Health Insurance Claim
Want to post any comments?
All hospital expenses, 100% covered
✓ Zero waiting period ✓ Zero deductions at claim
Recent
Articles
Can You Have Two Insurance Policies on the Same Car?
Team Acko May 20, 2022
Is a PUC certificate mandatory for vehicle insurance?
Team Acko May 13, 2022
Importance of cooling-off period in health insurance
Team Acko May 10, 2022
Understanding dental insurance in India: Cover, benefits, and claims
Team Acko May 6, 2022
Does health insurance cover brain surgery?
Team Acko May 6, 2022
All Articles
ACKO General Insurance Limited
2nd Floor, #36/5, Hustlehub One East, Somasandrapalya, 27th Main road, Sector 2, HSR Layout, Bengaluru, Karnataka - 560102
We’re socially active!
Download our app
Company
Support
CIN: U66000KA2016PLC138288
IRDAI Registration No: 157
Category: Non-Life Insurance
The use of images and brands are only for the purpose of indication and illustration. ACKO claims no rights on the IP rights of any third parties. The ratings are derived from reviews and feedback received from Google and Facebook users on their respective platforms. | *Savings of upto Rs. 50,000 have been calculated on the IDV of Rs. 18,00,000 and 0% NCB. Amount saved is in comparison to tariff rates. Product name: Private Car Policy - Bundled | UIN: IRDAN157RP0014V01201819 |
Trade logo displayed above belongs to ACKO Technology & Services Pvt Ltd and used by ACKO General insurance Limited under License. For more details on risk factors, terms, conditions and exclusions, please read the policy wordings carefully before concluding a sale.