What Is The Process To Claim Health Insurance?

Health problems and diseases can catch anyone at any time. Health insurance is important to keep yourself and your family financially secure. 

 

Insurance companies provide different health insurance plans. If an individual is admitted in the hospital, insurance companies will cover the medical, hospitalization and surgery expenses as per your insurance type. You can claim health insurance from your insurance provider.

 

Types of Health Insurance Claims

 

There are two types of health insurance claims:

 

l Cashless Claim Process

 

l Reimbursement Claim Process

 

What is Cashless Claim Process?

 

Cashless claim process means that you don’t have to pay any cash to the hospital. The insurance provider will cover cash or bill payment to the hospital directly. There are two types of the cashless claim process

 

Cashless Claim Process for Planned Admission to Hospital

 

Sometimes, hospital admission is planned. When you are having surgery or you need 2 to 3 days of hospital care or you would be hospitalized for a week; all this is planned with the doctor and you are admitted to the hospital with everything you need. 

 

In such cases, you will have to do the following:

 

-Inform the health insurance company about the treatment or hospital admission at least 3-4 days before you get admitted to the hospital.

 

-You can submit a cashless claim request to the insurance company. Now you can download claim forms from websites.

 

-Insurance company will check the documents, eligibility and your health insurance policy. 

 

-Finally, the insurance provider will cover the medical bills. 

 

Note: Sometimes, your health insurance claim can be rejected due to various reasons. The health insurance company will provide you with relevant reasons for rejection.

 

Cashless Claim Process for Unplanned Admission to Hospital

 

Medical emergencies can happen anytime. You or your family member will be admitted to the hospital without any planning. In such cases, you should:

 

-Inform the insurance service provider about the hospitalization within 24 hours after admission.

 

-Submit a cashless claim request.

 

-After checking the necessary documents, your eligibility and health insurance policy, the insurance company will cover the medical expenses.

 

-In case of rejection, the health insurance company will provide you with relevant reasons for rejection.

 

 

What is the Reimbursement Claim Process?

 

Insurance companies have a network of hospitals. They are listed in their portal and can be checked by you. When you don’t take treatment from the network hospitals, you need to use the reimbursement claim process. 

 

Reimbursement Process For Treatment

 

-In case of planned as well as the unplanned treatment you will have to pay the medical expenses along with the treatment cost. 

 

-You will have to share all the necessary documents, medical bills to the insurance provider.

 

-After the assessment, the insurance company will reimburse the amount into your bank account.

 

-In case of rejection, the insurance provider will inform you of the appropriate reasons. 

 

How Can I Inform the Health Insurance Company about medical treatment?

 

You have to fill the form of health claim intimation. The insurance company nowadays provides this form on their website. 

 

How Can I Submit the Health Insurance Claim Form?

 

Generally, you can easily download the health insurance claim form from the insurance company websites. Once you download the form, fill the necessary information and take necessary documents. 

 

Send the form to the insurance company brand office near to you. Also, you can contact the customer care for additional details. 

 

What are the documents required for Reimbursement Claim Process?

 

l Claim Form

 

l Medical certificate

 

l Summary from the nursing home

 

l Original discharge card

 

l Doctor consultation history

 

l Original bills

 

l Supporting reports and medical receipts

 

l Other certificate or report requested by Health Insurance company.

 

 

Future Generali is one of the leading insurance companies providing health insurance in India. For more details, visit general.futuregenerali.in