Health insurance no doubts provides the needed financial cushion in times of medical emergencies. You have one less thing to worry when you are backed up with a health cover. Unlike the motor insurance being a regulatory mandate, health insurance isn’t. Hence there is a neglect by many towards it. But considering its benefits, it should not be overlooked. Even for those who have one, aren’t fully aware of how to raise a claim without any hassles. This article helps to understand six things to know before you make a health insurance claim. 

#1 Tenure of the policy

The foremost thing to consider before making a claim is the tenure of the medical insurance policy. A policy that is beyond its coverage is termed as expired and it is equivalent to not having one. Since all policies are valid only for a specified duration, it is crucial to keep in mind whether the policy is active or not before a claim is made. A health policy, be it an individual plan, family cover or a critical illness insurance is essential and thus the tenure of the policy must be carefully monitored for ensuring timely renewal. 

#2 Inclusions and exclusion of the policy

Staying informed of the policy inclusions helps you know what are the treatments that form part of your coverage. While some of these inclusions might be critical, a few others might add value to your policy. Thus, checking the inclusions before your make a claim is essential. In addition to that, you must also not about the exclusions. These are the expenses that won’t be compensated for. Hence, keep an eye on them since you will be required to pay from your own pocket. 

#3 Knowing of the policy terms

Apart from knowing what is covered by your policy and what isn’t, it is also important to thoroughly read the policy terms. Your claim request won’t be honoured in case the policy does not cover that specific treatment. Hence, read the terms of the contract thoroughly.

#4 Informing the insurance company

When you raise a claim, it needs to be informed to the insurer within a specified duration. This period is mentioned in the policy document and keeping up with it is essential to not miss the timeline. For cases of planned hospitalisation, an approval needs to be obtained from the insurer. On the other hand, for emergency hospitalisation, it can be notified within 24 hours. 

#5 Documentation formalities

Depending on the type of health insurance claim, i.e. reimbursement or cashless health insurance, the documentation formalities differ. For cashless claims, the documentation required is minimal since the insurance company directly settles the bills with the hospital whereas reimbursement claims require an elaborate list of documents that are required which include test reports, invoices of treatment along with cost of medicines, if covered to receive a pay-out. 

#6 Proper communication

Lastly, ensure appropriate and timely communication is made to the insurance company. This ensures entire claim is smoothly processed and pay-out is received by you within a reasonable duration.

With the above pointers in mind, have a hassle-free medical insurance claim. With online policies now a trend, raising claims have also become faster and smoother. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.