The 2 Types of Health Insurance Claims You Can Take Advantage of

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Health insurance plans play a vital role in people’s daily lives since they protect them from the exorbitant costs of emergency medical care. Health insurance policies provide many advantages, including pre-and post-hospitalisation expenditures, ambulance fees, pharmaceutical prices, room rents, cumulative bonuses, and other benefits. 

Health Insurance Claims

If you are looking for a new health insurance policy, then do check out the Bajaj Allianz mediclaim plans online. 

If buying health insurance is important, then knowing how to make a claim is equally crucial. The health insurance claim process is vital since it helps people pay off their medical bills and gives them access to their accumulated advantages, including rewards, sum promised, claim amount, and more. 

Selecting an appropriate health insurance provider for prompt and hassle-free claim settlement is very necessary. You can check the claim settlement ratio to determine the health insurance provider’s capacity to settle policyholders’ claims properly. Therefore, while selecting a health insurer, you should ensure that their claims are processed quickly and efficiently. 

If you are still wondering how to claim health insurance, then please keep in mind that there are two types of health insurance claims that are generally used in India. 

1. Cashless claim settlement

Under cashless claim settlement, the insured needs to seek hospitalisation and treatment at an insurer-affiliated network hospital. 

The policyholder can receive cashless claims by showing their insurer-issued health card at the hospital counter. Under this claim, individuals have only a few out-of-pocket expenses, as the insurer pays the policyholder’s medical bill directly to the hospital without involving the insured. *

2. Reimbursement claim settlement

Individuals seeking hospitalisation in a hospital of their choice may utilise this claim settlement option. Under this approach, the insured can receive medical care at any hospital and pay for the incurred medical bills. 

By supplying the insurance with the required documentation, such as diagnosis reports, lab tests, medical bills, etc., they can receive reimbursement for their medical expenses. This method of claim settlement would be ideal for individuals who can cover the upfront costs of medication at the time of treatment. *

The cashless claim settlement option is preferred because it does not require the insured to make out-of-pocket payments. It helps the insured save money and ensures they receive quality care at the network hospital affiliated with their health insurance provider. 

You should always go for health insurance companies, like Bajaj Allianz,  that have a high claim settlement ratio. Before finalising your policy, you can also check with any friends or family members who have purchased Bajaj Allianz mediclaim to confirm your research.

Required documents for health insurance claim payment

Here is a list of a few documents that may be necessary for a smooth claim settlement

  1. Insurer-issued health card
  2. Medical consultation documents or files
  3. Duly signed claim form
  4. Investigation and diagnosis reports, such as X-Rays, CT scans, and lab findings.
  5. Medico-Legal Certificate (MLC) and an accident report (FIR) in case of an accident
  6. Prescriptions and pharmacy invoices
  7. Discharge summary documents
  8. Other related documents as mentioned in the policy copy.

* Standard T&C Apply

You can file any type of the claim based on your preferences, medical condition, budget, etc. It is crucial to inform the insurer of the hospital admission as soon as possible so that the insurance provider resolves the claim on time without any issues. 

‘Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.’

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