Process for making a claim on a health policy

[Dinesh]

Could you please tell me the normal process for making a claim on a health policy? Thanks in advance!

Regards

Dinesh

Similar Threads:

• What is the best option in Health Insurance, Family Floater policy or Individual Health Policy?
• Surrendering or making a policy paid-up?
• Health Insurance - If I include my parent in 5th year of the policy, will I get claim for their pre existing disease immediately?
• Case Study 23 - Policyholder supplies misleading and fraudulent documents in making a valid claim
• Process for making a claim on a Travel policy

[rohit]

In order to make a claim you will need to be hospitalized for a minimum period of 24 hours. In places where there is no hospital, considerations are different. Sickness will need to be certified by the government doctors.
The process for making a claim is as follows:
1. intimate the company when you get admitted to hospital (this could be done by anyone); provide the policy details
2. the policy covers the entire period in hospital. In addition, it covers your medical expenses over a maximum period of 60 days after discharge from hospital. If the sickness extends beyond 60 days, the cost arising from there from is not covered.
3. prepare to submit claim papers within 7 days from the date of fitness, or within 7 days after the 60 days are over (irrespective of whether you have recovered completely or not)
4. submit a duly filled claim form along with doctors prescription, medicine bills, reports (e.g., pathological, radiological, etc.), hospital discharge card and certificate from the doctor (certifying fitness or continuing illness)

[Natraj]

If the medicalim is not cashless then submit the following documents with To Claim form to the insurance company -

1) Bill Receipt and Discharge Certificate/card from the hospital.
2) Cash memos from the Hospital/Chemist(s) supported by the proper prescription.
3) Receipt and Pathological test reports from a Pathologist supported by the note from the attending Medical Practitioner/Surgeon demanding such pathological tests.
4) Surgeon’s certificate stating nature of operation performed and Surgeon’s bill and receipt.
5) Attending Doctor’s/Consultant’s/Specialists/ Anesthetist’s bill and receipt and certificate regarding diagnosis.
6) In case of Domiciliary Hospitalisation, receipt from a qualified nurse who attended the patient at his/her residence duly supported by a certificate from attending Medical Practitioner.
7) Certificate from the attending Medical Practitioner/ Surgeon that the Patient is fully cured.

[best]

Could you please tell me the normal process for making a claim on a health policy? Thanks in advance!

Regards
Dinesh

Documents to be submitted:
1.Claim form
2.First Consultation documents
3.Copy of admission advice
4.Discharge Summary
5.Prescription with bills
6.Test Reports
7.Any other document required by TPA.