Before understanding the process of a claim, you must know what the insurance company will look for.
Every insurer will accept your claim to be Genuine, and of course, they cross-check it.
If you regularly haven’t paid your premium on the date, there are high possibilities of claim rejection.
You must pay an amount when you claim the health insurance; the amount you claim must be decently above the amount you pay; otherwise, the claim may get rejected.
Inform the insurance company before you hospitalize or at least during hospitalization to receive the claim sooner.
Now, we’ll get into the process! Two possibilities make you claim health insurance; one is planned, i.e., an operation or a required hospitalization suggested by your doctor.
Another one is an emergency like an accident or heart attack. In both cases, get the reports from the hospital and request your doctor to fill out the form.
Submit these two files to the insurance company while you seek a claim.
The company will compare the medical expense, and sum assured, if the medical expenses are less, the claim will be approved.
If the estimated medical expenses exceed the sum assured, the company will pay a particular percentage of the hospital bill.
If you have been hospitalized in the network hospital, then the medical bills will be settled cashless by the insurer.
Avoid making frequent claims, as this will affect the premium to be paid.