Things to Consider While Making Health Insurance Claim

India has seen an increase in health insurance penetration since the COVID-19 pandemic struck. People have started realising the importance of health insurance better than ever. However, a health insurance policy is most useful when the insured can claim it as and when required. However, not many health insurance policyholders in India are well-versed in the details related to the health insurance claim process. But as claim settlement is one of the most important aspects of health insurance, hence we have curated a list of things that one must consider to make the claim settlement process smoother.

Keypoints to Consider While Making Health Insurance Claim

Check the things that you should consider while making health insurance claims which are listed below:

1. Waiting Period

A waiting period is that period during the policy tenure during which no claims are admissible. So, to avoid any discrepancy at the time of claim in the future, you must be aware of different types of waiting periods such as waiting periods for pre-existing diseases, initial waiting periods, and waiting periods for specific illnesses.

2. Inclusions And Exclusions

To avoid any confusion at the time of medical claim settlement, you must be aware of the inclusions and exclusions under your health insurance policy. To understand your policy better, you must read the policy document thoroughly. It keeps you prepared for the future, thereby saving you time in case of a claim in the future.

3. Terms And Conditions

Just knowing the inclusions and exclusions of a health insurance policy is not enough. You must also be aware of other terms and conditions like the co-payment clause, sub-limits, etc. If you fail to follow the terms and conditions at the time of making a claim, then the chances are high that your claim will be rejected.

4. Minimum Hospitalisation

If you were not aware until now, then you must be informed that a minimum of 24 hours of hospitalisation is required to be able to avail of health insurance policy benefits. However, certain daycare procedures do not require 24-hour hospitalisation. These are chemotherapy, radiotherapy, dialysis, etc. So, if you go for a tetanus shot at the hospital, then you should not claim the same as you would not be covered for it.

5. Network Hospitals

Every insurance company offering health insurance plans has tie-ups with hospitals known as network hospitals where the insured can avail of cashless treatment. You must check the list of network hospitals in your area to avoid wastage of time in case of an emergency as well as to avoid any confusion at the time of claim settlement. You can find the list of network hospitals in the policy document or at InsuranceDekho. You can also contact customer care executives in case any help is required.

Conclusion

Claim settlement is an important aspect of health insurance. Hence, when purchasing a health insurance policy for yourself and your loved ones, you must not only consider factors like coverage features, exclusions, type of policy, etc but also the claim settlement process offered by a Health Insurance Company. Also, understand the terms and conditions related to the claim settlement to avoid any discrepancy in the future. You can take the help of customer care executives at InsuranceDekho and they will be happy to solve your queries.

Must Read:

How To Make A Cashless Health Insurance Claim?

Difference Between Incurred Claim Ratio And Claim Settlement Ratio

Disclaimer: This article is issued in the general public interest and is meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive and should research further or consult an expert in this regard.