A comprehensive Health Insurance plays a significant role in safeguarding you against the financial burden during an unexpected health emergency. While there has been a promising growth in awareness about Health Insurance, sedentary lifestyle and increasing risk of ailments in the fast-paced environment have further elevated its importance. Claim filing is an importance aspect and ensures you get the comprehensive coverage as mentioned in your policy. Hence, it is important to be vigilant about the entire claim process including claim filing to minimize the mistakes that can lead up to its rejection. The below pointers will help you navigate through the usual mistakes:  

Comprehensive understanding of Health Insurance policy
Many people buy health insurance without having a thorough understanding of their coverage. They are often unaware of their policy’s specific features & benefits, limitations, terms & conditions, waiting period and other relevant information. These can vary from policy to policy. Due to this, they may end up claiming for medical expenses which are not covered in their policy. This results in claim rejection and a consequently bad experience for the insured. 

To avoid this, policyholders need to make an informed decision.  Sign the proposal form themselves after correctly stating their details, reading and understanding the terms & conditions, reviewing important aspects such as deductibles, co-payment, out-of-pocket limits, insured services, network of healthcare providers and waiting period. 
Besides, one should read the policy certificate and conditions once you receive it and in case of any disconnect, contacting your respective agent or provider can not only help avoid risk of getting your claim rejected, but also help utilize all the benefits of your policy.

Opting for a network healthcare provider 
When it comes to filing your claim, it is important to check whether your healthcare service provider is a part of your insurer’s network or not. Availing services at a healthcare centre in the network of your insurer enables cashless treatment amidst many other benefits. 

Ensure proper documentation and share complete medical history 
Documentation of your medical records and bills is a pre-requisite to filing claims. Ensuring all documents are complete and to the best of your knowledge & understanding, ensures successful filing for claims. Always provide relevant and correct information as discrepancy in details shared can result in unwanted delays and even rejection of the claim. You should always keep your medical records, invoices, receipts and payment-related documents handy. 

Sufficient health coverage 
 While opting for a Health Insurance, you should always make sure that it covers all your requirements.  A coverage that rightly fits the healthcare needs of your family, covers existing medical conditions, understands health history & required healthcare services, and safeguards you from the  unwanted out-of-pocket expenses. A proper risk assessment, necessary research and taking expert guidance can get your essential needs covered and in the long term, eliminate the possibilities of getting your health insurance claim rejected. 

Disclosing existing or past medical conditions
It is extremely crucial to share your existing medical conditions or past treatment history with your insurer. There are certain policies which don’t cover some ailments or medical conditions. And when your claim request is for an ailment based on a disease that you had in the past and that was not disclosed to the insurer while buying the policy, it may lead to your claim getting rejected. 
A health insurance policy is essential to protect you and your loved ones from expensive healthcare expenses and eliminate the related worries. While a comprehensive Health Insurance can safeguard you from spending huge amounts of money on medical bills, rejection of a claim can be distressing. Learning about the common mistakes and avoiding them can make sure you receive all the benefits of your policy and guarantee a worry-free life & a secured future. 

The writer is Head- Claim & Underwriting, Care Health Insurance.


By admin