What Is Claim Intimation in Health Insurance?

When a disease strikes or a health emergency arises, having a health policy brings a sigh of relief. However, there is an important step that policyholders must be aware of: claim intimation.  This step is very important to get the benefits of buying a health insurance plan. Despite its significance, many people still don't know what is claim intimation in health insurance, and why it matters.
In this article, we will explore the concept of claim intimation, process, timing, and what happens if you miss it.

Contents

• Claim Intimation in Health Insurance
• Importance of Claim Intimation in Health Insurance
• How to Intimate a Health Insurance Claim?
• What Documents Are Required to Intimate a Claim?
• When Should You Intimate a Health Insurance Claim?
• What If You Miss the Claim Intimation Timeline?
• Conclusion
• Frequently Asked Questions 

Claim Intimation in Health Insurance

In simple words, claim intimation is about informing your insurer that you are going to make a claim against your health insurance policy. After intimation, the insurer starts verifying your policy terms and moves forward with the claim process.
Claim intimation is the beginning of the actual claim process. In this process, you do not have to submit bills; you just inform the insurer about what is going to happen. 

Importance of Claim Intimation in Health Insurance

Claim intimation sets the tone for the claim process. Timely claim intimation can avoid claim rejection or processing delays.
Here is an example: You have been hospitalised after a sudden illness. You focus on treatment while your family does the paperwork. If you or your caregivers have not informed the insurer, the claim might get delayed. 
This is especially important in the insurance claim procedure for cashless claims. Intimation ensures that the hospital gets paid directly by the insurer, and you don’t have to worry about the bills.

How to Intimate a Health Insurance Claim?

Intimating a claim is no longer the complex process it once was. Insurers have now simplified the process. Here’s how you can do it:

• Calling the helpline: Most of the insurers have a toll-free number where you can give an alert about a claim.

• Using the mobile App or website: Many insurers feature online claim intimation. It lets you register a claim within minutes.

• Email support: Sending an email with all necessary details can also work.

• In-person visit: In some cases, especially for older policies, you might still have to go to a branch. However, it has become very rare nowadays.

During the intimation, you will be asked for basic details like your policy ID/number, name, relationship with the insured, hospital name, diagnosis, and expected date of admission. 

What Documents Are Required to Intimate a Claim?

Insurers often request some supporting documents at the time of claim intimation in a bid to keep things transparent. You should remain prepared with:

1. A copy of the health insurance policy

2. A valid photo ID of the insured, 

3. Doctor’s note or medical recommendation for hospitalisation, and

4. Hospital details (including contact information and registration number).

Remember, this is not the documentation for a full claim. It is simply for the purpose of validating the legitimacy of your intimation.

When Should You Intimate a Health Insurance Claim?

For planned hospitalisations, the general rule is to inform the insurer at least 24 to 48 hours before admission. It gives them enough time to verify and approve the treatment, especially in case of cashless claims.
For emergency cases, the window is a little bit shorter (usually within 24 hours of admission). This might sound like a short window, but most of the hospitals do it on your behalf.
And if you are wondering what is the process of claim intimation, it is essentially this: notify early, give basic details, and wait for approval before starting treatment at the hospital.

What If You Miss the Claim Intimation Timeline?

Most of the insurers have timelines in their policy document, and breaching those can result in claim rejection, delay in processing, or requirement of extra documentation and justification.

Some insurers acknowledge genuine emergencies, especially if you are hospitalised in a critical state or an unconscious state. They might consider extending the claim intimation timeline.

Conclusion

Understanding what is claim intimation is more than just an industry term. It is the very first step in the process that leads to your medical bills being taken care of. Besides giving you peace of mind, it can protect you financially. When you inform the insurer, you respect the policy terms. It makes your case stronger, thus resulting in a hurdle-free claim process. 
In moments of health problems, timely intimation helps you better focus on recovery.

Frequently Asked Questions 

Here are some common questions about Claim Intimation in Health Insurance

Is claim intimation required for all hospitalisations?

Yes, claim intimation is necessary to ensure smooth processing and avoid claim denial. Claim intimation is necessary for both planned and emergency hospitalisations.  

Can I intimate a claim online?

Yes, you can intimate a claim through the insurer’s website or mobile App. Most of the insurance providers feature this facility for quick and convenient communication.

What’s the deadline for intimation in case of an emergency?

In an emergency case, you should inform the insurer within 24 hours of hospital admission.

Who can intimate the claim on behalf of the patient?

A family member, hospital staff, or an authorised person can intimate the claim on behalf of the patient.

Do I need to submit documents at the time of intimation?

Yes, you may require basic documents like ID proof, policy details, and initial medical reports in support of your claim intimation.

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