Health Insurance

How To Claim Health Insurance

Keeping up with health has become a top priority in today's time since one does not know what may hit you. Therefore, one needs to be prepared all the time and be aware of your health and wellness.…

Keeping up with health has become a top priority in today's time since one does not know what may hit you. Therefore, one needs to be prepared all the time and be aware of your health and wellness. As an Indian citizen, we need to analyze the nation's healthcare conditions that directly affect us. In cooperation with the west, India's healthcare scenario is not very encouraging. We may have a boosting economy, but the healthcare sector bears a sad face. India's enormous diversity is a massive challenge to the healthcare system. With that in mind, the authorities and Insurance providers have a progressive outlook toward the health sector. They have formulated various strategies that the public needs to be aware of.

It is but the truth that people tend to ignore to secure their future for lack of interest in health care policies. In doing so, they forget to analyze a long-term benefit, which is necessary and mandatory. This comes from a lack of awareness about Healthcare insurance. Therefore, let us brief ourselves on what exactly is health insurance.

Importance of Health Insurance

Health insurance is a deal made between the patron and the insurance company to take care of the insured's medical expenses in case of any significant illness or accident. Health insurance is highly recommendable these days because of the high medical costs in the private sector, which can be heavy on the pocket for any common man of India. Owing to its purpose, having proper health insurance ensures a great deal of help during the hour of need. The government of India encourages taking health care insurance It brings enormous taxation relief to an individual, as premium paid on Health insurance is tax-deductible under section 80D of the Income Tax Act. This garners an optimistic approach to the healthcare facility in India.

What is Health Insurance Claim?

Healthcare insurance assists you with your immediate requirement of medical help, taking care of the trouble of vast amounts of medical bills. Having proper health insurance takes care of the burden that accumulates at the time of an absolute emergency. The health insurance includes various benefits and covers significant areas of medical expenses such as consultation fees, ambulance charges, expensive medical tests (X-rays, MRI, CT scan, etc.), pre and post-high-priced hospitalization charges. Also, one needs to be extra particular when choosing the right healthcare insurance. Therefore, is it commendable to be learned or informed about what health insurance claim is?

Health Insurance Claim Types

Generally, in a health insurance claim, the insurer's request is made to the insurance company to facilitate the services covered in their health insurance policy as per the requirement befitting the insurer. This further settles for choosing the type of health insurance claim, which would provide a maximum medical benefit. In doing so, the claimer can either opt for a cashless claim or reimbursement claim

Cashless Claim:

In this, all the expenses generated after the medical treatment of the insured, the concerned insurance company will be responsible for paying the bill to the respective hospital. Mainly, the insurance company has a tie-up with the hospitals, therefore, claiming a medical treatment through them comes with security. The patient thus is relieved from the pain of pulling out the hard cash during an emergency. But while claiming any health insurance, one needs to make sure that all the terms and conditions of the health program are thoroughly checked and accepted for the smooth running of the claim process.

Reimbursement Claim:

Unlike a cashless claim, where the insurance company has impaneled hospitals, in reimbursement claim, the insurer can choose his/her choice of hospital for the medical treatment even when it is a non-impaneled hospital. But here, the insured has to pay all the medical expenses involved in the procedure, and then he/she can claim reimbursement. To avail of this particular claim, one must provide essential documents that include originally generated bills to the insurance company. Only after verifying the documents under their own company's policy, they may further proceed with the payment of the accumulated medical invoice. But if under any circumstance, the necessary treatment doesn't fit or isn't covered in the claimed insurance, then the insurance provider can reject the claim.

Therefore, it is advisable to read the terms and conditions of any claim process before submitting it.

Most traditionally, there are some criteria laid down for ensuring healthcare insurance. Since, as a responsible citizen of India, we need to assemble essential and necessary information attached to any healthcare policy. While claiming health insurance, the overabundant of documents is required. This, for the applicant, serves as an assemblage for proofs. Thankfully, due to digitalization, physical paperwork has decreased, and things have become convenient for the applicant. However, even after the technology intervention, one cannot be done without submitting these documents. Therefore, one must have an insight into what all to be sent to acquire healthcare insurance.

Health Insurance Claim Documents:

1. Age proof: The first and foremost requirement while buying health insurance. It can be a-

● Voter ID Card

● Pan Card

● Aadhaar Card

● Driving License

● Passport

● Birth certificate


2. Identity proof: This is necessary for documenting the records, which will further benefit the coverage offered to the insured.

● Voter ID Card

● Passport

● Aadhaar Card

● Driving License


3. Address Proof – Your health insurance company will send various communications on your postal address. You can also submit any of the following for verification;

● Ration card

● Driving license

● Passport

● Rent agreement if applicable

● PAN Card

● Aadhaar Card

● Utility bills like electricity bill, telephone bill, etc.


4. Passport-size photographs (on insurer's demand)


5. Medical reports (on insurer's request)


6. Proposal form duly filled in and signed


(*Disclaimer: the documents mentioned above are pointed in general. Sometimes the insurer may have different document requirements. Therefore, the list may vary)

Securing your health means securing your future and having health insurance further solidifies your take on life as you venture well-armoured. Health is wealth. So, choose your healthcare policy now and get insured for life.

Health Insurance Claim Process

The procedure to avail cashless claim for a health insurance policy includes the following steps:

  1. Contact the insurance help desk at the hospital.
  2. Verify the identity by providing the ID card provided by the insurer.
  3. Once the verification process gets completed, the hospital provides a pre-authorization form to the insurance provider.
  4. The insurer then reviews the submitted documents and processes the claim according to the terms and conditions of the policy.
  5. Some health insurance companies also provide a field doctor to make the hospitalization process easier for the insured.
  6. Once the formalities are completed, the claim is settled as per the terms and conditions of the policy.

Health Insurance Claim Conclusion

Buying health insurance can be one of the smartest decisions you can make for yourself and family. In today's day and age, lifestyle and environmental changes have led to a complete shift in people's health dynamics. Although the medical infrastructure in the country and world has improved and hence, we have better facilities for everything. Still, at the same time, all these treatments and facilities cost much higher. To facilitate that, having health insurance by your side takes off all your worries on any kind of financial pressure, and you are free to choose the best treatments for your loved ones. Hence, do not think twice before investing in a health care plan as it is bound to give you immense benefits and relief at the same time.

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