You can make your health claims hassle free

The moment of truth for any customer is at the time of claim. Therefore timely and hassle free processing of claims hold tremendous importance not only for the customer but also for the insurance company. One can make the process of claiming health insurance hassle free by following these five simple steps:

It’s important to be clear about the policy one intends to take in order to avoid any hassle or heartburn in the future. One should always read and understand the terms and conditions of a policy carefully. The insurance agent should be asked to explain any term that one is not able to comprehend.

The most important part of a policy is the Proposal form which acts as the basis of the contract with the insurer. Therefore one should fill the complete form by self and sign it. Filling of proposal forms should not be left on agents. One should definitely refrain from making false declarations while taking the policy.  In case the claim is not made in accordance with agreed term it becomes difficult for the insurance companies to honor the claim.

Many customers get surprised and disappointed when asked to pay for a part amount while claiming for medical or hospitalization expenses. Some policies impose co-payment if treatment is taken in a hospital outside the insurer’s network. It is, therefore, imperative to know the existence of this clause and to check whether the chosen hospital is in the insurer’s network or not. 

The documentation checklist required for health insurance claims usually includes first prescription of the doctor, treatment related documents, investigation reports (X-rays, ECG, lab reports etc.), original medical bills and receipts of the hospital, labs, doctors etc., besides an admission and discharge summary form the hospital. In case of an accident-related hospitalization, a copy of the FIR will also be typically required. One should submit original documents. Insurers do not reimburse bills that are photocopies.

Following these simple steps can make the claims journey a transparent and seamless experience.