Health insurance allows the policyholder receive the best medical care during a medical emergency; without having to worry on the medical bills. You can get health insurance coverage and initiate a claim, to get medical bills settled. Nowadays, the insurers offer both the cashless facility and reimbursement; to ease the process of claim settlement.
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Listed below are the types of health insurance claims:
Cashless Claims: The insurance companies have tie-ups with the best network hospitals; where insurers directly settle medical bills with hospitals. This reduces the out-of-pocket expenses. So, if an insured is admitted to a network hospital for a medical emergency; then the insured only need provide the medical insurance number at the billing counter and raise the cashless claim.
The hospital directs the medical bills to the insurer and the bills are then settled. Cashless claims are a convenient way to avail the best medical treatment; without having to worry on the costs.
Reimbursement Claims: Reimbursement claims are initiated if the insured has received treatment from a hospital; which is not a part of network hospitals as mentioned in the policy documents. Here, the insured have to pay the medical bills out of pocket and later initiate a claim to get the amount reimbursed.
See Also: Health Insurance Benefits
Given below are few tips which will help settle claims easily and conveniently:
When availing health insurance policy, you must first mention facts regarding your health. An insured is expected to disclose medical history and his current health status in the proposal form at the time of buying a health insurance policy.
You must mention any chronic illness suffered, any surgeries you underwent in your childhood along with any genetic diseases. You must also mention if you are a smoker/drinker. Your health policy premium is determined based on your medical condition at the time of policy purchase. Hiding facts on your health may lead to the rejection of claims. The rejection of claims beats the purpose of availing insurance.
To ensure smooth claim settlement; the insurer must not hide health-related issues from the insurer. You must also mention changes in health condition to the insurer. In most cases, the insurers do not change the terms of acceptance; unless they suspect some serious non-disclosures. Your insurer has the right to reject claims. So, make sure to disclose all facts correctly to avoid rejection of claims.
See Also: Types of Health Insurance Plans in India
Insurers readily settle the insurance claims on active health insurance policies. Most of the people aren’t aware of the fact; that delaying premium payment; may result in the policy lapsing. In case your policy lapses, you are no longer covered by your insurer and all the premiums paid till date are useless. Your insurer may reject claims if your policy expires due to late premium payments. If you make premium payments on time, the insurer will not hesitate to settle claims.
Documentation is important for claim settlement. The insured must submit all original copies while making the claim. The documents include medical bills, bills of diagnostic tests, as well as bank account details for the claim.
You can contact the insurer on their 24*7 helpline number. In case you need any assistance or have any grievances vis-à-vis the policy claim; then you must get in touch with the insurance company. The customer care executive will take care of your grievances and help resolve any issues.
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