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Got your company’s health insurance? Make sure you complete these 5 steps to make the claims process smooth later

Create digital copies of all the policy documents, scan and mail them to your family members or upload them on cloud drives

July 14, 2021 / 09:31 AM IST

Your corporate health insurance should technically cover you from day one. But there are formalities that you’ll have to fulfil before it actually takes effect. There are forms to fill and profiles to update. If these aren’t done in time, it is likely that your claim may not be paid because of an unfulfilled formality.

So, here’s a list of five steps that you must take, as soon as you start on your new job. And mind you, even your company’s HR might not proactively inform you about these steps. It is therefore important that you stay on top of the terms and conditions of the health policy.

Update your family’s personal profile

Once you get your employee ID, the first thing you should do is update your family’s details on the company’s insurance portal. You or your family members can’t make claims until the details are filled on the insurance portal. Generally, it is assumed that it is the HR’s job to do this, but it’s not. So, take this up on priority as soon as you can.

Get the e-card from your employer

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Usually, after the health insurance policy is issued, you will receive a TPA (third party administrator) card for you and your family members. This card will be helpful in case you want to get cashless facilities at a hospital. If you misplace or forget the physical copy of your card at the time of hospitalization, you can submit the e-card along with an ID proof and avail cashless facilities. For either case, you first need the TPA card to be generated and sent to you.

Know your benefits well

To ensure that you don’t face any difficulty or denial during the claim, read the policy document thoroughly, understanding what is covered and what is not. Corporate health insurance policies usually come with certain restrictions, room-rent limits, co-pay clauses for specific procedures etc. Carefully go through all these features and benefits. Further, it’ll also be helpful to go through the claims procedure itself, and take your family through it as well, so when the time comes you know exactly what needs to be done.

Prepare a list of documents and network hospitals

Generally, every insurance company has an agreement with a certain hospitals for providing cashless facilities to their customers. These hospitals are referred to as network hospitals or empanelled hospitals. In case there’s any emergency hospitalization in the future, instead of going through the policy document, having a ready list will help you quickly decide which hospital to go to.

Let your family know about the policy

You might be the person getting hospitalised, so your family members will have to go through the claims process. It is therefore important that your family members are aware of the health insurance policy you get from your office. Take them through the policy details, share all the lists you’ve created, and store the copy of policy documents in one place that can easily be accessed. Further, give them an overview of the claims procedure. As an additional measure, you can also create digital copies of all the policy documents, scan and mail them to your family members or upload them on cloud drives.

Although completely relying on your corporate health insurance policy might not be a good idea, it may come in handy if your personal health insurance has a waiting period for certain diseases, or you’re getting your parents as well covered for their pre-existing diseases. So, if your company is providing you a health cover free of cost, you should enjoy the benefits, while they last.

The points listed above might seem of little importance right now, but they are crucial to ensure that you’ve done everything right before making a claim. So, go ahead, spend a couple of hours and get these in order. It will pay off when the time comes.
Mahavir Chopra is the founder, Beshak.org, a consumer awareness platform for insurance
first published: Jul 13, 2021 09:41 am

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