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Health Insurance / Medical insurance

Proven Hacks to Ensure a Successful Health Insurance Claim

Shriya Garg
By Shriya Garg
Published: Saturday, 25 July 2020
Updated: Saturday, 25 July 2020 05:28
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In a world as fragile and frail as the one right now, people are getting increasingly concerned about their health. Many people are turning vegan, many have frequented exercising and watching their weight, and those with lifestyle diseases have become more cautious.

Of course, the uncertainty and unpredictability of life are what make it worth living. But when medical conditions and ailments catch us off guard, lives can be disrupted. The disruption is not only in terms of mental and physical trauma; but also in terms of the damage done to our finances.

Let’s be clear- hospitalization and attention to medical emergencies are not cheap in any corner of the world. But when it’s a matter of life and death, people disregard the monetary costs.

But what if a specific health crisis or medical emergency strikes you or your family, which requires a filthy amount of expenses? That is why you need a reliable health insurance policy at your disposal. It might seem like an additional expense at first, but it will save you loads of money when you or your family have to undergo a medical procedure.

That is precisely what any insurance is at its core. Insurance is a phenomenon that is centuries old and dates back to 2250 BC when Babylonians used a specific type of loan insurance for marine businesses. The fundamental thought behind introducing insurance was the instinct of mitigating risk aversion and surviving uncertain times. The whole idea of modern-day insurance, in its essence, stems from human evolution.

However, health insurance claims can be tricky in many precarious situations. We list out proven hacks to ensure a successful health insurance claim.

Read the fine print of your policy.

Before sealing the deal, you should read the policy being sold to you carefully by the insurance agent or company. The insurer selling the system will verbally assure you of everything going your way. However, it is best to go through the entire proposed policy with a fine-toothed comb to find discrepancies.

This will prevent any ‘surprises’ coming your way in times of actual emergencies. For instance, the policy you are buying right now may not cover any pre-existing conditions or future ailments due to it. This can make you burn a hole in your pocket. Hence, always carefully read the fine print of your health insurance. Read all terms and conditions before zeroing on one policy.

It is also advised that people buying a health insurance policy be up-to-date with changes in the structure of insurance claims before filing one.

Go for a cashless policy.

Opting for a cashless policy instead of one where you have to file for reimbursement is better any day. The cashless option will make things very easy for you; all you have to do is walk in with your insurance card and let the experts do their job. The cashless process reduces paperwork to almost nil, so you have no stress or tension when you’re letting the doctors do their magic on you.

Additionally, you have to inform your insurer/agent about your ‘trip’ to the hospital, and all will be taken care of from then. Also, the primary benefit of going cashless is that you don’t have to pay when you are discharged; all financial talk will be done by your insurer with the hospital administration directly.

All the latest details to be filled carefully.

If you don’t want your health insurance claim to be rejected by the insurance company, be transparent with your insurer and don’t hide details. If you fill in incorrect information about you or your family, you could lose the health insurance claim you make in the future.

Remember, insurance companies are pros at catching bad lies or untrue facts stated by people. Your safest bet avail a successful health insurance claim is to fill in information and particulars candidly. This could include anything from your and your family's medical and health history, you and your family’s occupational details and other necessary information.

Follow protocol when filing for a claim.

With cashless claims, there is not much that you have to do apart from informing your insurer within 24 hours of getting admitted to the hospital.

With reimbursement claims, you have to get all the paperwork in one place, collate it, and file for an application. The final documents should include all paper trails- from your test reports to doctor’s prescription, from medical bills to discharge papers. If the protocol is not followed and the paperwork is not complete, your claim could be rejected.

Understand the special clauses.

Most insurance policies will have special clauses like ‘waiting period’ or requirements related to ‘pre-existing conditions.’ Before filing for a health insurance claim, know these particular inputs to avoid getting your application rejected. For instance, if your insurer does not include hypertension as an illness, all ailments related to hypertension will be rejected.

Filing for a successful health insurance claim is no biggie. You only need to follow the rules and adhere to the insurer’s guidelines. Alternatively, a less-known insurance hack is to invest in term insurance plans with money back at the end of the tenure. This way, you don’t have to worry about the worst-case scenario - rejected claims!

Everything is a cakewalk! Remember, if your claim gets rejected for some reason, you can always rectify and apply it to achieve victory.

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Proven Hacks to Ensure a Successful Health Insurance Claim
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