How To Claim Children Health Insurance?

Children health insurance plans are especially designed to meet the health insurance requirements of children. During their growing years, children are more prone to diseases owing to their relatively lower immunity levels than adults.

Just like you plan for the future of your child, you should also take a customised health insurance plan for your kid which can meet all of their medical requirements. Besides, ensuring quality treatment during medical emergencies, a children health insurance plan also ensures regular medical checkups for them. This helps in early detection of diseases and timely medical treatment.

Children Health Insurance Claim Process

A health insurance policy can be claimed either through a reimbursement process or a cashless process. You can opt for a cashless process in a network hospital of the insurance company. But if you are hospitalised in a non network hospital of the insurance company that you would need to pay the bills from your pocket and after that you can ask for reimbursed amount from the insurance company.

Children Health Insurance - Cashless Claim Process

Through cashless mode you wouldn't need to pay a single penny from your pocket you would require to submit needed documents to the hospital authorities and they will then complete the further process.

Step 1: Inform the insurer
The first thing one needs to do after getting hospitalised is to inform the insurer about the hospitalisation and expected treatment and expenses. For this you can either contact the insurer directly or can contact the mediclaim department of hospital they will then complete the process further.

Step 2: Show the Claim Card
Then the hospital authority will ask you to show you the claim card and provide policy related documents such as policy number, policy provider etc.

Step 3: Provide Details
You are required to provide policy related details and id proofs to the mediclaim department for verification purposes.

Step 4: Scrutiny by the insurer
After receiving all the documents the insurance company will send an agent to the hospital for scrutiny purposes and to verify the authenticity of the event and hospitalisation.

Step 5: Claim Settlement
The further process will be completed by the hospital itself. And the claim will get settled.

Children Health Insurance - Reimbursement Claim Process

When you choose to get the treatment of your child at a non-network hospital of the insurance provider, the claim is settled in a reimbursement manner -

Step 1: Inform the Insurer
After getting admitted in the hospital the policyholder is required to inform the insurance company about hospitalisation and expected expenses.

Step 2: Get Medical Treatment and Pay the Bills
Get the right medical treatment for your child and settle the medical bills with the hospital.

Step 3: Submit Claim Form
Get a claim form from the insurance provider and fill it mentioning details such as hospitalisation expenses, doctor's fee etc for the evaluation purpose of reimbursement amount. Submit the claim form to the insurer.

Step 4: Submit Required Documents
After submitting the form, you would need to submit other required documents to the insurer such as medical bills, medical reports, pharmacy bills, doctor’s prescription, etc.

Step 5: Scrutiny By the insurer
After receiving all the documents the insurance company will send an agent to the hospital for scrutiny purposes and to verify the authenticity of the event and hospitalisation

Step 6: Claim Settlement
If the insurance company feels satisfied , then your claim will get settled within 2-3 weeks and you will receive the reimbursement amount in your provided bank account.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.