Important things to consider before filing your health insurance claims – CNBC TV18

Important things to consider before filing your health insurance claims – CNBC TV18


Filing a health insurance claim is not stressful. With correct knowledge and preparation, policyholders can avoid normal damage and ensure hassle -free claim settlements.

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PhonePe provides a guide to help customers to make informed decisions and to help the process of claims smoothly navigate before purchasing a policy.

Pre-blessed idea

Learn your policy details

“Before purchasing a health insurance policy, policyholders must review the coverage details, the waiting period for the pre -existing conditions, and the room fare range,” PhonePe recommends.

Insurance Regulatory and Development Authority of India (IRDAI) has introduced a simplified customer information letter (CIS) to help policyholders easily understand the major terms.

Check the insurer’s claim settlement ratio

“A high claim settlement ratio indicates a strong track record of claim approval. Customers should also review co-paying segments to avoid surprise later, ”PhonePe recommended.

See for the No-Claim Bonus (NCB) benefits

“Choosing a policy with NCB helps to increase coverage for every claim-free year,” the phone note. This feature can be beneficial in management of long -term health care costs.

Understand the range of room fare

“Selection of policies with high or no room rented caps prevents additional out-off-packet expenses for upgrading the hospital room,” PhonePe.

Being aware of these boundaries beforehand can help avoid unexpected costs.

Steps to experience a smooth claims

Network hospitals simplify the claims process by enabling direct insurer-hospital billing. Policy holders should inform their insurer or third-party administrator (TPA) within 24 hours to be hospitalized and at least two to three days in advance for planned admission.

Accurate paperwork is important for a successful claim. Policy holders should keep:

  • Doctor’s tips
  • Lab test report
  • Detailed hospital bill and discharge summary

For accident -related claims, accurate documentation is even more important.

“Many insurers offer dedicated relationship managers who assist in claim filing and documentation,” PhonePe explains. The demand for their support can accelerate the process.

Honest and complete revelations are important.

Hiding already existing conditions or medical history may claim reject. Claims associated with undisclosed conditions may fall under the already existing waiting period section and can be denied.

“The range of room rental can be more than doctor’s fees and additional charges,” PhonePe Warning. Policy holders should confirm the eligibility of their room with their insurer or broker before entering.

Consulting insurers or brokers for cost estimates before employed treatments can help policyholders select hospitals within their coverage.

Additionally, outpatient treatment should not be incorrectly admitted to the hospital. Valid documents such as diagnostic reports and doctor’s certificates can help support real claims.

“Many insurers offer mobile apps to track the claim position and track online claims,” ​​PhonePe Note. These digital equipment provide transparency and rapid resolution.

“If policyholders face claims issues, they should reach their insurer’s helpline,” PhonePe recommends. Increasing unresolved claims for insurance Lokpal can also support.

(Tagstotransite) Health Insurance (T) Health Insurance Claims (T) Insurance Claims (T) Filing Health Insurance Claims