How To Fill A Health Insurance Claim Form?

Health insurance plans are available for policyholders with various features and benefits. These benefits can be accessed at the time of the claim settlement. As for the health insurance plans, they come with a waiting period. 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 claimed amount along with the other attached features under the plan.

How To Fill A Health Insurance Claim Form?

To fill out a health insurance claim form, it is important to 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 out 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:

• Insurance group number, member number, or group number
• Name of the person who received the services of the plan
• The reason for visiting the hospital (accident, medical condition, etc.)

Steps To Fill Your Health Insurance Claim Form

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

1. Obtain The Relevant Documents

In the case of cashless claims, you may attach documents like a copy of your proof ID, an FIR copy in case of an accident, etc. While, in the case of reimbursement claims, you must attach the receipts, consultation papers, invoices, medication bills, etc. with the claim form. So, you must have 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 printout of the claim form and complete it with all the required information, including your name and policy number. You can either get the print from the internet or you can get the same from the hospital desk.

3. Take Copies

The next step is to make copies of each document once you have all the required paperwork and a properly completed claim form, as this will help reduce errors during the claim settlement process. Additionally, it ensures that you re-file your claim in case your document gets lost.

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

The two types of health insurance claim settlement procedures that can be considered when claiming health insurance  are as follows:

1. Process of Cashless Claim Settlement

You can receive cashless treatment at a health insurance provider's network hospital by showing your health ID at the hospital desk and then receiving cashless claims under this type of claim process.

2. Reimbursement Claim Settlement Process

This type of claim can be received at any hospital of your choice. You must pay your medical bills yourself under this procedure and then file a claim with the discharge documents. The insurer will refund the guaranteed amount to your bank account.

Conclusion

You must fill in the claim settlement form with utmost clarity and be precise with the details you fill in the form. If any of the details in the form are incorrect, or if the claim request is submitted for a medical condition that is not covered by the health insurance plan, your claim request will almost certainly be rejected.

Also Read: 

HDFC Ergo Health Insurance Plan: Easy Steps To Renew Your Policy

Does Cataract Surgery Come Under Health Insurance And The Cost Of Surgery In India?