
Health Insurance Policy
The surfacing of lifestyle ailments and rising communicable and vector-borne diseases have brought genuine health concerns. Despite staying healthy, falling prey to diseases is highly possible.
A tryst with hospitalization is not uncommon. Acute and constant medical attention seems to be the new normal.
While healthcare and medical facilities advance by leaps and bounds, costs of treatments and medical care skyrocket.
The unfortunate fallout of medical inflation: financial burden, monetary stress, depleting personal savings, and at times, debts.
In these times of uncertainty, if there’s one key solution to securing healthcare needs – it’s health insurance plans.
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Claim settlement process for Health Insurance
The claim process is nothing but the request from a policyholder to the insurance company to compensate/make payment for the medical treatment costs incurred by the health insurance policyholder. There are two types of claims:
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Cashless claim
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Reimbursement claim
For both types of claims, health insurers follow a set of processes which have to be completed within a few days to a few weeks of the hospitalisation. Typically, the process involves informing the insurance company about the medical procedure/emergency within a specified time frame, submitting a claims form and the required documents. The insurance company then investigates the documents to release the payment.
Health Insurance Cashless Claim Process
Cashless claim is an agreement between the insurer and the network hospitals to allow policyholders treatments without any payments from the policyholder. In this type of claim, the insurer pays directly to the hospital. The policyholder does not have to make the payment and then receive it back as reimbursement from the insurance company.
This process, typically, follows these steps:
Get treatment at a hospital part of the network of the insurance policy
Submit a health insurance policy claim form at the hospital
The insurance company sends an approval to the hospital or raises a query in case of missing information
Health Insurance Reimbursement Claim Procedure
In this type of claim, the health insurance policyholder has to make the payment to the hospital, which is then reimbursed by the insurer upon following the reimbursement process, as follows:
The policyholder is required to fill a claims form and submit to the insurer along with the medical and hospital bills
The insurer then investigates the documents
If the claim is approved, the insurance company sends an approval letter. In case of rejection, a rejection letter along with the reasons is shared with the health insurance policyholder.
Reasons to buy a Health Insurance Policy Online
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Customized Policy
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Convenience of Comparing Policies
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Hassle-free Transactions
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Secure, Faster and Time Saving
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Easy claim settlement
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Tax Advantages
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Policy Renewal
Why do you need to compare Health Insurance Plans?
Once you have a clear picture of your requirements, select a few plans from different health insurance companies. Compare different plans. Look for these differences and identify benefits:
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Premium
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Add-on offered
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Pre and post hospitalization coverage range
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Illnesses and diseases covered
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Flexibility – portability option, possibility of adding a new member, increasing or decreasing sum insured, etc.
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Claim settlement ratio of the company
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Network hospitals
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Cashless claim facility
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Waiting period for pre-existing diseases
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Exclusions
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Co-payment and sub-limit clauses