How to insure against hassles at the time of health claim settlement

Settling claims has never been an easy process, for insurers or for consumers. However, the process can be made simpler if consumers go in for digitally enabled insurance advisors who will help consumers choose the best policy as per their needs

Balachander Sekhar

While everyone talks about insurance and the kind of financial cushion it provides, one of its most important aspects is claim settlement. No insurance policy can serve its purpose until and unless it provides proper claim settlement to consumers.

As per industry estimates, around 38 percent of health insurance companies settle claims within five business days on average. In the wake of the pandemic, the country has seen a surge in COVID-19 claims that are yet to be settled. These numbers show the urgent need for speedy claim settlement to make insurance more popular. While the industry is working collaboratively to solve the issues related to claim settlements and make it a faster and smoother process, consumers should also be aware of a few tips and tricks so that they can make claim settlements hassle-free for themselves.

Share complete information

It is important to disclose all the necessary information like past medical history, family history, details of important assets while filling up the forms. One should attach all the necessary bills, copies of insurance cards and other relevant documents while submitting the forms. Without proper support of documents, claims cannot be validated. The bulk of the challenges faced by consumers arise from non-clarity on the documents that need to be submitted. This has been particularly observed in the case of hospitalisation, where the patient’s family faces issues with last-moment claim settlements due to incomplete information or lack of proper understanding of policy terms and conditions while filling up hospital admission forms.

Understand all the policy terms and conditions

Insurance policy documents are lengthy and detailed, whether one purchases a policy online or offline. Many consumers, thus, choose to read the terms and conditions superficially, a big mistake. Typically, it is during claim settlement that they get to know that they had missed out on some valid points.

For instance, consumers buy a health insurance policy assuming that a particular health issue is covered in the policy (let’s say dental insurance). These kinds of instances keep happening, because consumers do not read the document properly but go by their assumptions. It is during a dental health check-up and/or dental procedures that they realise that the insurance is not covered in the policy. Understanding such details can be challenging, with so many insurance companies offering different kinds of policies.

Opt for cashless facility

People often get involved in numerous formalities like fee payment, deposits and managing lengthy paperwork during hospitalisation. At such a time, when one’s family needs emotional support and presence, financial hassles only add more stress. Hence it makes sense to opt for a cashless claim. This makes the overall claim settlement process easier, quicker and seamless. The best part is, the policy buyer does not have to worry about cash handling and arrangements because the hospital and the insurance company will take care of it. It is important that consumers keep proper records of all treatment-related documents, which are to be provided to the third-party administrator department/s of hospitals. Proper documentation makes the cashless claim settlement process even smoother.

Settling claims has never been an easy process, for insurers or for consumers. However, the process can be made simpler if consumers go in for digitally enabled insurance advisors who will help consumers choose the best policy as per their needs and requirements and financial capabilities from the multiple policies on offer.

Go To Home Page Click Here

Leave a Comment

Your email address will not be published.