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How To Fill A Health Insurance Claim Form?

Published On Nov 12, 2021 11:00 AM By InsuranceDekho

Health insurance plans are packed with a set of features and benefits for their policyholders. These benefits and features under a purchased health insurance plan can be availed by the policyholders at the time of the claim settlement procedures. As the plans come with a certain waiting period, during which you cannot avail the services of your health insurance plan. Therefore, after the waiting period, you may request to claim your health insurance policy and avail all of its accumulated benefits. You can either make a cashless claim or a reimbursement claim based on your financial budget.

You must go through a procedure to file a claim for your health insurance plan. You must submit a claim form along with other relevant documents to your health insurance provider. Then after proper verification of your documents and submitted details, the health insurance provider will approve your claim request and you will get the claim amount along with the other attached features under the plan.

How To Fill A Health Insurance Claim Form?

To fill a health insurance claim form, you must collect the hard copy of the form. You can either get the form from the hospital desk or you can take a print from the official website of your health insurance provider. Then, you must fill the form with all the necessary details and submit the duly signed form along with the other mentioned documents. Some of the basic details that you must be aware of before filing your claim form are:

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  • Insurance group number, member number or group number
  • Name of the person who received the services of the plan
  • Coinsurance or dual coverage under the plan
  • The reason for visiting the hospital (accident, compensation, etc.)

Steps To Fill Your Health Insurance Claim Form

Let us look at some of the steps that you can follow to fill your health insurance claim form conveniently:

1. Obtain The Relevant Documents

In case of cashless claims, you may attach the documents like a copy of your proof ID, FIR copy in case of accident, etc. While, in case of reimbursement claims you must attach the receipts, consultation papers, invoices, medication bills, etc. with the claim form. So, you must keep the necessary documents ready beforehand. To get a list of the relevant documents, you must carefully read the fine print of your policy.

2. Fill The Claim Form

Take a print of the claim form and fill it with all the necessary details like your name, policy number, etc. You can either get the print from the internet or you can get the form from the hospital desk.

3. Take Copies

After you have all the necessary documents and a duly signed claim form, the next step is to take the copies of all these documents as it decreases the errors in the claim settlement process. It also makes sure that you re-file your claim in case of loss of documents.

4. Review And Send The Documents

The last step is to cross check the list of the documents and then review the details entered. Finally, you can send the documents to the health insurance provider and patiently wait for the documents to be verified and processed before getting the approval and claim amount for your purchased health insurance policy from the health insurance provider.

Types of Health Insurance Claim Settlement Procedures

Following are the two different types of health insurance claim settlement procedures that can be considered when claiming your plan:

1. Cashless Claim Settlement Process

Under this type of claim process, you can receive cashless treatment at the network hospital of the health insurance provider by showing your health ID, issued by the insurer, at the hospital desk and then receive cashless claims.

2. Reimbursement Claim Settlement Process

This type of claim can be received at any hospital of your choice. Under this procedure, you must clear your medical bills yourself and later file a claim with the discharge documents. The assured sum of money will be reimbursed by the insurer to your bank account.

Conclusion

You must fill the claim settlement form with utmost clarity and be precise with the details filled in the form. If any of the details in the form are invalid or if the claim request is raised for a medical condition that is not included in the health insurance plan, then there are high chances of facing rejection on your claim request filed at the time of a medical condition.

Also Read: Does Star Health Insurance Cover Lasik 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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