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How To Claim Maternity Health Insurance?

Published On Mar 18, 2021 5:30 AM By KANIKA WADHWA

Motherhood is one of the most pleasurable experiences. However, without proper planning, it may become difficult to enjoy. Hence, before getting ready for motherhood it is important to get prepared financially and emotionally. Wondering, how? Here we tell you how.

In order to safeguard parents and let them enjoy the most beautiful phase of their life, insurance companies provide maternity health insurance in which all expenses related to pregnancy and newborn are covered.

How To Claim Maternity Health Insurance?

What is Maternity Health Insurance?

It is a tool that safeguards you from all pregnancy-related expenses and helps you in providing your newborn baby with a premium quality treatment. You can buy maternity health insurance either as a rider with a basic insurance policy or as a dedicated standalone health plan. In both plans, you will get coverage for hospitalization expenses related to both baby delivery options, that are, normal delivery and cesarean delivery.

Some of the benefits of maternity insurance include coverage for pre and post natal and pre and post hospitalisation expenses. Pre Hospitalisation includes expenses incurred upto 30 days before the date of admission. Other expenses such as room charges, doctors consultation etc are also covered under a maternity health insurance plan.

How To Make A Maternity Health Insurance Claim?

In case you are near to holding a baby in your arms, then your insurance company must be informed about it immediately 

Hence, within a few hours of hospitalization, you must inform your insurance provider to take the claim settlement process ahead. The claim can be both made either in reimbursement or cashless manner depending upon the hospital you have chosen. If you choose a partner or network hospital of your insurance provider, the claim will be settled in a cashless manner, otherwise in a reimbursement manner. 

Step 1: Inform the Insurer
The first and foremost step after getting hospitalized is to inform the insurer about the hospitalization and provide all the required details.

Step 2: Claim Form
Fill out the claim settlement form provided by the insurer and duly sign it. After completing all the required information, submit the form to the respective insurance company.

Step 3: Documents Submission
After submitting the claim form you would need to submit the required documents for verification purposes , it would include address proofs , identity proofs, policy documents etc.

Step 4: Submission of Bills
Besides documents, the  insurer will ask you to submit all medical bills and invoices including, hospitalization bills, consultation fees of the doctor, and various others to evaluate the reimbursement amount.

Step 5: Enquiry by the Insurer
The insurance company will then send an agent to the hospital for verifying all the details and medical bills provided by you.

How To Make A Maternity Health Insurance Claim

If you have visited a network hospital, the claim will be settled in a cashless manner. And if you have visited a non-network hospital, you will initially have to settle the hospital bill yourself. After all the submission and verification of documents, you will get the reimbursement amount within 2-3 weeks and your claim will get settled by the company.

Documents Required for Maternity Health Insurance Claim

In order to file an insurance claim you should have the required documents in hand at the time of emergency. Given below are the documents needed to claim a maternity insurance policy.

  • Duly filled in claim form
  • Policy documents
  • Admission advice
  • Discharge summary
  • Fitness certificate
  • KYC documents
  • Consultation bill
  • Original hospital bill
  • Pharmacy bill

Cases Where You Can’t Claim Maternity Insurance (Exclusions)

Before buying a health insurance plan, it is advisable to go through all the exclusions and inclusions of the policy in detail. Some of the common exclusions of health policy that you should be aware of are mentioned below:

  • Expenses incurred on vitamin pills and tonics not mentioned in the plan
  • Doctor’s visit for regular checkup
  • Diagnostic tests and doctor’s consultation during pregnancy
  • Treatment costs regarding infertility treatment

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.

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