Documents Required for Health Insurance Claim

• Written by Jyotsana Shekhawat

  Reviewed by Munmi Sharma

• favorite0Like

  favoriteBe the First to Like

  • content_copy Copy Link Copied! Share on Facebook Share on Linkedin Share on Twitter Share on WhatsApp

  ios_shareShare

Buying a health insurance policy is necessary to protect your lifetime savings during a medical emergency. It ensures ultimate peace of mind in times of crisis. However, we only learn the policy's value when a medical emergency arises. There can be situations when the claim is rejected, such as when the policy has lapsed, or the premium has not been paid. There is a procedure to file a claim. It is not a hassle if you are well informed about the health insurance claim process.

Care Health Insurance has a convenient claim settlement process. We offer a simple and quick claim procedure. Visit our company's official website and connect with anyone from 24,800+ cashless healthcare providers. This article will teach you about our Care Health Insurance policy's required documents and claim process.

Documents Required to Claim Health Insurance

You would need the following documents to claim your health insurance policy-

Claim Related 

• Duly filled and signed claim form
• Pre-authorisation form (for cashless claim)
• Valid identity proof
• Policy details that includes the name of the insured, policy number, illness and address
• First Information Report(FIR), if applicable
• Indoor case papers
• Ambulance receipt
• Any other document required to assess the claim, in case of any fraud
• Other documents required for cashless facility

Medical Documents

• All diagnostics and medical reports
• Original payment receipts, hospital bills, and discharge summary
• Pharmacy bills and prescriptions
• Doctor’s prescription recommending hospitalisation
• Doctor’s prescription advising medicines, diagnostic tests, and consultation

Claim Process for Cashless Treatment

You can get a cashless facility at more than 24,800+ cashless healthcare providers across the country. Find a network hospital where you can avail of cashless health insurance treatment.You need to follow the following steps:

• Get the pre-authorization form available at the hospital's insurance / TPA Desk.
• Send it to the customer support team.
• You will get an approval letter after verification.
• For further any query from the claim management team, you or the hospital staff must respond to it.
• You can carry on your treatment as per the doctor's advice and file for a reimbursement claim a cashless request gets rejected.

Claim Process for Reimbursement 

In case the treatment is availed from a non-network hospital, the insured has to bear the medical expenses initially. However, they can file for reimbursement right after the discharge. This facility is also helpful if cashless treatment is denied by the insurer.

You need to abide by the following steps to claim for reimbursement:

• Submit a claim form along with the required documents, as per the policy terms & conditions
• You will receive an approval letter sent by the claim management team
• Insured to respond to the query raised by the claim management team
• The team will communicate the reason in case of rejection

Final Word!

The insured should not delay in intimating the insurer regarding the claim as it may lead to claim rejection. Make sure that all the facts are handy and the information provided is correct. It is crucial to follow the guidelines mentioned in your health insurance policy to ensure that your claim is settled on time. 

Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.