Formalities for a health insurance claim
Here we are explaining the full health insurance reimbursement and claim process. You can apply your claim under a Health insurance policy in the following two ways:
- Cashless Basis
- Reimbursement basis
Cashless claim process:
For a claim on a cashless basis, your treatment must be only at a network hospital of the Third Party Administrator (TPA) who is servicing your policy. You have to ask for authorization for availing of the medical facility on a cashless basis as per procedures decided and in the prescribed form. Please read the policy document when receive it to make yourself aware of the process rather than wait for a claim to arise.
Reimbursement claim process:
Read the clause relating to claims in your policy document when you receive it to ensure that you are aware of the procedure and the documents needed for making a claim on a reimbursement basis. When a claim arises you should inform the insurance company as per the methods required. After hospitalization, you have to verify that you obtain and keep documents handy such as claim form, discharge summary, prescriptions, and all test and medicine bills that you should submit for a claim.