Mediclaim Insurance Policy: Tips to File Reimbursement Claims

Published On 21 Nov 2019 By Prashant Srivastava

Filing a Reimbursement Claim

Claiming for reimbursement of mediclaim insurance would be tedious if you are doing it for the first time. How to get the reimbursement claim form? How to submit it? What documents are required? Within how many days should the form be submitted? A lot of questions may boggle your mind when it comes to filing a reimbursement claim after getting discharged from the hospital.

However, you should not worry. Just read this article and you will get the solutions.

Reimbursement Claim

When you buy a health insurance policy in India, the insurance company lets you enjoy Cashless Claim and Reimbursement Claim benefits. The cashless claim is filed on getting treatment at network hospitals whereas the reimbursement claim is filed when you don’t get medical treatment in a network hospital i.e. a hospital which is not in the panel of the insurance company. You pay all hospital bills and other expenses related to treatment from your own pocket. To get these expenses reimbursed, you need to file a reimbursement claim.

How to File a Reimbursement Claim?

Filing a health insurance reimbursement claim is not daunting. The process is very simple. Follow these steps:

  • In case of planned treatment, inform your insurer about the treatment within the stipulated time (exact time is given in the policy wording).
  • In case of an emergency case, the intimation should be given to the insurance provider after being admitted (refer to policy wording to know the time period).
  • Get the treatment and pay the hospital bills yourself.
  • Collect documents from the hospital such as investigation reports, final discharge summary, pharmacy bills, hospital bills, receipts, indoor case papers, a valid ID proof, treating doctor’s report, original consultation notes.
  • Ask the insurer to email you the reimbursement claim form or download it from the official website of the insurance company. You can also contact InsuranceDekho for the same.
  • All the documents should have a signature, cost price, patient’s name, document number and serial number.
  • Get the form signed by the policyholder and the treating consultant.
  • The documents and the claim form should have the official hospital seal.
  • Attach the xerox copy of your health card and medical documents to the claim form.
  • Send all the documents by courier to the address specified by the insurance company.

Note: Before sending the documents, review all the documents carefully. And also make sure you make copies of all the documents and claim form for future reference. If any documents are missing, the claim may be rejected or the insurer may ask you to submit those documents as soon as possible.

Click here to know Claims Ratio in Health Insurance

In case of any doubt or query, feel free to call InsuranceDekho. Our experts are ready to help you.

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