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Tips To Ensure Smooth Claim Settlement Process

Updated On Oct 11, 2021

Due to the spread of the global pandemic the sales of health insurance plans have boosted as people have come to realise the importance of having financial backup in case of a medical emergency. Recently, there has been a rapid hike in inflation in the different sectors like the health sector, resulting in the basic costs of treatments have increased, thus burning a hole in the pockets of the people. Health insurance plans offer a wide range of features and benefits at the time of the claim settlement process. Before claiming a health insurance plan, the policyholders must overcome the waiting period of the plan which is pre-decided by the insurer depending on the medical conditions. At the time of the claim settlement process, the policyholders can avail all their accumulated benefits like no claim bonuses, rewards, discounts, etc.

Claim settlement process is integral as it helps in overcoming the high costs of treatment at the time of a medical emergency. To experience a smooth and hassle-free claim settlement process, you must look for a suitable health insurance provider. To choose an appropriate health insurer you must consider the claim settlement ratios of the companies and compare them. It shows the efficiency of the insurers to settle the claims of the policyholders. Claim settlement procedures can be made easy and hassle-free by following certain tips.

Tips To Ensure Smooth Claim Settlement Process

Tips To Ensure Smooth Claim Settlement Process

Following are some of the key tips that you must consider to ensure smooth claim settlement process when availing your health insurance plan:

1. At Least 24 Hours Hospitalization

To get hassle-free claim, make sure that you are requesting a claim for a hospitalization of minimum of 24 hours. People with less than 24 hours of hospitalization must claim specific features like daycare procedures, etc. of the policy. Make sure to not waste your entire plan on less than 24 hours of hospitalization treatments.

Must Read: Tips For Quick And Hassle-Free Claim Settlement Process

2. Consider Sub-Limits

There are certain features in the health insurance plans which have restrictions on them like under room rents you can choose a certain type of room during hospitalization. Therefore, it is important for the policyholders to look after the applicable sub-limits under the policy terms. Anything requested beyond the sub-limit can be denied under your claim request.

3. Waiting Period of Certain Medical Conditions

Waiting period is the time period for which the policyholder has to wait before availing the features of the purchased health insurance plan. These waiting periods depend on the medical conditions. Therefore, make sure that you file a claim after the waiting period of a specific disease. People must buy a health insurance plan as early as possible to overcome the waiting period.

4. Co-Payments

This is a limiting factor which impacts the claim settlement process of a health insurance policy. Under the co-payment, the policyholders are supposed to pay a certain fraction of the medical bill from their pocket. Therefore, the policyholders must be aware of their co-payment clause beforehand, so that they are not financially exhausted.

5. Exclusions Under The Plan

Each health insurance policy comes with a certain set of inclusions and exclusions. Exclusions are the set of features that are not a part of the health insurance policy, therefore any claim request raised for such features or medical conditions will be denied by the health insurance provider. Hence, the people must carefully go through their policy terms to file a claim without any inconvenience and rejections.

Apart from the above-mentioned tips, it is also important for the policyholder to buy a health insurance plan from a reliable health insurance provider. Claim settlement process becomes more easy and efficient when documents required for the process are kept handy well in advance.


The claim settlement process of the health insurance policy purchased by the policyholders can be made quick and smooth by following the above-mentioned tips. The policyholders must thoroughly read the fine print of their health insurance plan to make sure that there is no confusion at the time of the claim settlement procedure.

Also Read: Types of Health Insurance Claim Settlement

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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