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Health Insurance Claim Process

Claim Process for Reimbursement and Cashless Hospitalization

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94%

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8100 +

Network Hospitals across 500 cities

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About Health Insurance Claim

Mrs. Narang is overwhelmed as her husband is back home after spending a couple of weeks in the hospital. But, now she is concerned about how to file a health insurance claim? She does not want to trouble her husband and has no knowledge about the process. Every time she piled up the papers, she found it a mess. Thus, in this article, we have jotted down all the steps for a smooth health insurance claim process. So that you do not need to face the haphazard like Mrs. Narang and file a claim easily. 

What is the Health Insurance Claim Process?

A health insurance claim is a request from a policyholder to the insurer to avail of the benefits under health insurance policy during a medical emergency. It can be done either by cashless facility or reimbursement. Health insurance companies follow a set procedure to meet the claim. It is not at all a daunting task if you are aware of the health insurance claim process. For a hassle-free claim settlement, you have to inform the insurer about your hospitalization within the stipulated time and submit important documents.

Steps for Health Insurance Claim Process

Once you have invested in health insurance to secure your savings, it is vital to understand the claim process in both cashless hospitalization and reimbursement cases to get the hassle-free settlement. Read below the steps in health insurance claim process:

Cashless Hospitalization Claim Process:

  • Submit health insurance policy claim form on hand at the insurance help-desk of the hospital and submit it to us through email or fax
  • An approval letter will be sent from the side of the Religare’s claim management team
  • Query might be raised from the side of our claim management team
  • After that, you will have to file expense reimbursement

Planned Hospitalization Claim Process:

  • Submit the Religare Health Insurance claim reimbursement form and attach all the required documents along with the form
  • Our claim management team may raise a query if required
  • Approval letter will be sent by the claim management team
  • In the case of claim rejection, reasons will be communicated
  • Show the health insurance card provided by us to get cashless benefit at the network hospital
  • Submit a medical certificate issued by the hospital/doctor
  • Duly submit the claim form to the insurance company
  • Submit the discharge form issued by the hospital/doctor
  • Submit the report issued by a medical examiner
  • Provide the Police Report or FIR if a personal accident is covered under the plan
  • Post-mortem report
  • Death certificate
  • Submit the medical documents issued by the hospital/doctor

Claim Process for Accidental Injuries:

  • Immediately intimate us via writing or call along with the particulars required
  • Duly submit our claim form
  • Submit Police Report or FIR if a personal accident is covered under the plan
  • Submit the medical certificate issued by the hospital/doctor
  • Show the health insurance card provided by us to get cashless benefit at our network hospitals
  • Submit the discharge form issued by the hospital/doctor
  • Submit the report issued by a medical examiner
  • Provide the medical documents issued by the hospital/doctor
  • Post-mortem report
  • Death certificate

Claim Process in Case of Accidental Death:

  • Submit the Police Report or FIR if a personal accident is covered under the plan
  • Post-mortem report
  • Death certificate
  • Submit the medical documents issued by the hospital/doctor

With Religare Health Insurance, getting a claim is no more a cumbersome task. Follow the above steps based on the situation and get your claim timely without stress.

How Long does it Take to Process a Health Insurance Claim?

You have to inform us within 48 hours and have to file the claim within 15 days of the hospitalization. You also need to fill the claim settlement form and submit the required documents to our claim management team. After analyzing your situation and verification of the submitted documents, our claim management team processes your claim amount.

>> Check: Health Insurance Claim Settlement Ratio

List of the Documents Required for Health Insurance Claim Process

You can check the below list of the documents that you need to collate to file a claim.

  • Duly complied and signed claim form
  • Doctor’s prescription and referral letter
  • Diagnostic tests and reports
  • Original bills, receipts and discharge papers from the hospitalization
  • Original bills from pharmacy/chemists
  • Provide the Police Report or FIR if personal accident
  • Post-mortem report
  • Death certificate
  • Policy details including number, name of the policyholder, nature of the illness, address and other required information

Therefore, investing in health insurance is a wise decision to protect yourself and your loved ones in case of any medical emergency. A good acquaintance with the various aspects of the claim procedure helps you to avoid medical insurance claim rejection. For quick claim- settlement check the health insurance plans offered by Religare Health Insurance. The claim procedure is simple, and its insurance advisors help you 24x7 if you are stuck in an awkward situation while filing a claim.

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