Health Insurance Plans

pays for your hospital bills for diagnostics, surgery etc.

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A Short Guide to Know The Claim Process After Hospitalization

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Thanks to the rising levels of pollution and sedentary lifestyle, people are falling victim to the innumerable life-threatening diseases. Health Insurance claim proves to be of great relief at the time of any unforeseen event.

Insurance is a wise decision to be taken to incur the cost of Hospitalization and other expenses. If you are faced with financial constraints in the future and have to incur the inevitable hospital expenses, you can heave a sigh of relief.

Let us have a quick look at the Claim process after hospitalization.

The first step is to fill a claim request form along with a summary from the hospital, the consultation report of Doctor, medical bills, prescription, and investigation reports and medical, legal certificate in the case of Accident should be submitted to the insurance company while applying for the claim. After evaluation, the insurance company intimate the Insured about the different documents which has to be submitted along with the request form. In case of emergency, TPA should be informed immediately. Before claiming, the insured has to be sure that the hospital falls under the norms of network hospital or not. All information should reach at the TPA within 24 hours of hospitalization in case of an emergency.

After receiving all the above mentioned documents, the application is further processed and the nominee or the claimant is informed about it. Then the decision is taken on behalf of the documents sent and the insured is informed about the acceptance or rejection of the claim. If all the data proved to be correct than the claim is made otherwise the rejection letter is sent to the insured stating the reason of rejection. Rejection can be on behalf of not following the norms of the company or may be disclosure of some relevant information.

Any person who is in the age group of 18 to 80 years can avail the benefit of this policy. Mediclaim can be in the range of 5 lakh till 50 lakh. Policy can be taken by the customer for himself or for any of his family members. Family members enjoy some fixed amount of discounts on policy.