Health insurance policies are primarily about securing financial coverage towards medical aid for yourself and your family. It is a smart and prudent way to prepare for unforeseen medical events. Health insurance not only protects your finances but more importantly, gives you access to quality healthcare when you need it the most. However, despite a range of benefits offered, people find the health insurance claim-process tiresome, giving the entire policy bad press.

The method of getting the cost of the medical services that you have availed, covered, constitutes the health insurance claim process. A few guidelines can explain to you how to claim health insurance money when the need arises.
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Reimbursement claims come into the picture when the hospital you are at is not a network hospital, or if the claim has been denied. In this case you need to ask for a copy of all the original documents from the hospital, because these same documents need to be submitted to the insurance company for their assessment. Post the assessment of the claim, the money will be transferred to your account.

In essence, the major difference between the two is that in case of a cashless claim, your savings and liquidity remains unaffected.

STEPS FOR REIMBURSEMENT HEALTH INSURANCE CLAIMS
Below are steps you need to follow to claim for reimbursement under your health insurance:

1. Contact the Insurer through Toll-Free Healthline - Like cashless treatment, here also you need to contact the insurance provider three days before the hospitalization so that the health-relationship manager can help you with the process. In case of emergency, contact the insurer within 24 hours of admission.
2. Hospitalization - Avail your treatment in the hospital and settle all the bills from your end. The costs levied during the period of admission can be claimed along with pre and post-hospitalization expenses. Collect all the necessary documents such as case papers, hospital bills, discharge summary, investigation reports, pharmacy bills etc.
3. Submit Your Claim - The duly filled claim form needs to be submitted along with the list of documents mentioned above. A copy of the form is included in the policy kit you receive at the inception of the term, or you can download it from the insurer’s website. Submit the claim form and all the documents to the corporate office of the insurer, or the nearest office. This needs to be done within 15 days from discharge.
4. Claim Assessment - By analyzing the information provided by you, the insurer accepts the request and processes the claim. In case of insufficient information or a lack of documents, the insurer asks you to provide the same. Failing to provide necessary documents within the given period may lead to claim rejection.
5. Claim Service Associate - On request from your end, the insurer can provide you with a claim service associate to navigate through the paperwork and other documents.
6. Claim Settlement - On approval of the claim from the insurer, you will receive the claimed amount to your bank account via NEFT or through DD/Cheque.
   

Conclusion

Do not get intimidated by the financial jargon in the insurance policy. By scrutinizing every line, one can easily claim and settle their dues with the insurer. Making health insurance claims has become more accessible; all you need to do is- read the steps carefully and take action accordingly.