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Health Insurance Claim

Claim Process for Reimbursement and Cashless Hospitalization

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7.5% Discount
10% Discount

Your premium is Rs.

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I

94%

Claim Settlement Ratio (OND 2018)

II

8100 +

Network Hospitals across 500 cities

III

400 Lacs+

Lives covered

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 the smooth claim process. So that you do not need to face the haphazard like Mrs. Narang and file a claim easily. But, before we jump onto the steps, it’s good to understand the two ways you can settle the claim. Here we go!

Cashless Claims

Reimbursement Claims

Under a cashless basis, you can file the claim only when you are admitted to network hospitals. You have to submit the required documents within the stipulated time to the insurer. After successful verification of the documents by the claim management team, the claim amount is directly paid on your behalf to the respective network hospital.

Under the reimbursement basis, you can file the claim post-hospitalization. First, you have to pay your medical expenses, and later you have to submit the required documents within the stipulated time to the insurer. After successful verification of the documents by the claim management team, you get the approval. You will receive the amount of reimbursement for all the expenses up to the sum insured.

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.

Claim Process for Cashless Hospitalization

So, let's start with the claim process for cashless hospitalization.

  • Get the health insurance policy claim form from the insurance help-desk of the network hospital and fill all the required details.
  • Collate all the medical bills, diagnosis and doctor’s prescription
  • Submit all the required documents along with health insurance policy claim to your insurance company
  • Once your documents will be verified by the insurer you will receive an approval letter from the side of the claim management team
  • Query might be raised from the claim management team
  • After approval, your hospitalization expenses will be borne by the insurer directly to the respective hospital

Claim Process for Reimbursement

Under reimbursement you can follow below simple steps:

  • Fill health insurance claim reimbursement form and attach all the required documents along with the form
  • Submit the form and the required documents to the insurer
  • Claim management team may raise the query
  • Once they cross-check and verify the documents you will get an approval letter from the claim management team
  • After approval, your hospitalization expenses will reimburse you by the insurer up to the sum insured

>> 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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