Do's and Don'ts While Filing Health Insurance Claim


Do's and Don'ts While Filing Health Insurance Claim

Health insurance has ideally become a necessity. Whether its corona pandemic, critical illnesses, or chronic diseases, it acts as your savior and keep you at bay from financial constraints that you may face during a medical emergency. Therefore, when you strike with any unforeseen medical eventualities, the first thing you want is hassle-free and timely claim settlement. But, you should wise enough to understand that your mediclaim policy may have a strictly restricted window when it comes to claiming settlement. Thus, before you jump onto the steps for claim settlement, you should follow these do's and don'ts tips to avoid claim rejection. Here we go!


The do's of filing health insurance claim are:

Read Exclusions List: Do check the exclusion list. It has all the situations/treatments/medical procedures/conditions not covered under the policy. So, make sure you have gone through all exclusions to avoid rejection over your mediclaim.

Furnish Required Hospital Bills: Do furnish all your bills to the claim management team and hospital TPA within the stipulated period. From diagnosis to hospitalization, surgery, medicines, and doctor's prescriptions and keep the original and duplicate copies of all the required documents for future purposes.

Timely Intimation: Do intimate to the claim management team and hospital TPA desk about your hospitalization within 24 hours in case of emergency and before 48 hours in case of planned admission, necessary for claim settlement.  

Information about Pre-existing Disease: Do share your information about your pre-existing disease before you buy the policy. It will help you to get the coverage and claim accordingly.

Admitted in Network Hospitals: Do admit at network hospitals to avail cashless claim settlement. It is a wise way to get the best possible treatment without worrying about cash.


While filing health insurance claims the don'ts are:

Ignore Exclusions: Don't ever ignore the exclusions list of your mediclaim policy. Read all the terms and conditions and diseases/treatments/procedures mentioned under exclusions to ensure claim settlement on time.

Tear Hospital Bills: Don't ever tear your hospital bills until you get the final claim. All the documents like doctors' prescriptions, diagnoses, and bills are essential for filing and verifying a claim. 

Non-Network Hospitals: Don't go for cashless hospitalization at network hospitals. You can avail of a cashless hospitalization facility only at network hospitals.

Delay: Don't ever delay in intimation and submitting documents at the hospital desk and the claim management team. It can cause a verification problem and unnecessary delay in your claim. 

Hide Pre-existing Diseases: Don't ever hide pre-existing diseases at the time of buying a mediclaim policy. If the claim management team comes to know about it later, they can reject the claim immediately. 

>>Click Here to Know What is Pre-Existing Diseases (PED) Clause in Health Insurance


Therefore, investing in a health insurance policy, especially during the corona pandemic outbreak, is a wise decision to protect yourself and your loved ones from a medical emergency. Rightly, acquainted with do's and don'ts for health insurance claim procedure helps you avoid last-minute chaos and claim rejection. However, for a quick claim- settlement, you can opt for the Super Mediclaim Policy offered by Care Health Insurance. It has a simple claim procedure, and you can apply in any of our 22900+ cashless healthcare providers in India as per your comfort. 

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.

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