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File Medical Insurance Reimbursement Claims

  • Author :
  • TATA AIG Team
  • Published on :
  • 20/07/2022

If the pandemic years have taught us anything, it is that health is a variable that can change at any given time. People who thought they were healthy and thus would not be affected were infected with the virus. Hospitals were at bursting capacity, with people losing their lives because of a lack of care. And honestly, the average Indian was not even able to afford care. Healthcare bills were mounting in families, and most people who could find their way out of this situation were those with medical insurance.

A good health insurance policy helped thousands of Indians during the pandemic. The Medical insurance system works by you paying affordable premiums periodically, and then the insurance company pays for the insured if they need medical help. Since the money you pay toward your health insurance policy covers a certain sum per your contract, you can get the best care money you can buy without worrying about making payments. Most insurance companies today offer you cashless claims, but there may be situations where you cannot go to a network hospital and need to opt for a reimbursement claim. But, getting mediclaim reimbursement can seem like a daunting task. If you have health insurance with Tata AIG, you need not worry about your mediclaim reimbursement process. Our health insurance policies have an easy and hassle-free reimbursement claim process. We also have a notable claim process with claim specialists helping you all the way.

Moreover, our medical insurance offers you a cashless service in over 7200+ hospitals. But if you still need assistance from a non-network hospital, you will not face any trouble. You will be able to claim your money in a simple process online. So, compare the health insurance policies we offer and choose the right fit for you. With this in mind, let us look at how to claim medical insurance in India.

How to Claim Medical Insurance in India?

If the thought of mediclaim reimbursement daunts you, you need not worry. The process is very simple. You have nothing to worry about if you have the right documents required for mediclaim reimbursement and follow the right protocol. But if you are still wary, here are some guidelines to follow on a reimbursement claim.

  1. Sort through all of your receipts, bills, and medical records. Organise things in the sequence in which they occurred. Ensure that the documents required for mediclaim reimbursement are ready with you and in order. These documents should have details such as the name of the patient, documentation number, registration number, amount spent, insured person's signature, etc.

  2. Approach your insurance provider and ask for a reimbursement claim form. Since most insurance providers now have an online presence, you should be able to find a form online on their website.

  3. Once you find the claim form, you should find the instructions on how to claim health insurance. Follow the instructions on the screen and have the necessary documents with you.

  4. Read the claim form carefully and ensure you understand what is being asked of you. Then, based on that, fill in the information carefully. Keep in mind that there is no room for errors here. Only fill in details that are accurate and which you have a proof for.

  5. Attach the documents required for mediclaim reimbursement along with your form. The document you will need to attach include-

  6. Xerox of your medical insurance or insurance card;

  7. Certificate signed by a board-certified doctor;

  8. A copy of the hospital discharge card;

  9. The appropriate pathological reports;

  10. A copy of the First Information Report in case of an accident claim;

  11. The original hospital bills and receipts;

  12. The original pharmacy bills;

  13. The investigation report, if applicable;

  14. Your NEFT details for the settlement of the claim;

  15. Duly filled CKYC form if the claim amount is above ₹1 lakh.

  16. Ensure that all the documents you are providing are the original documents. The insurance provider will not accept copies of the original. The documents should be in chronological order and be attested as needed. When you have all the documents ready, you need to add your signature to the claim form and submit it.

  17. Once you have submitted the documents and your claim form, you need to wait to hear back from your insurance provider. They might have some questions during the verification process or may need some additional information or documents. Cooperate with them and provide them with what they need. This will speed up the process and help you get your claim faster.

  18. Once the verification process is complete, you should get the claim amount in your bank account. The verification process can take some time so having patience is key.

  19. If you wish to submit your claim offline, you can take the necessary documents and visit your insurance provider's office. They will give you a physical form to fill out and attach the documents as requested. You need to submit the physical copies of your original documents to get the claim amount.

You can ask any claim specialist to check if you have everything in place and then submit your form to them. Post this, you will need to wait for verification and to hear back from the information company as the case may be. You may need to visit the office a few times if additional documents are required.

Thus this is the answer to how to claim medical insurance in India.

Conclusion

Hopefully, you have understood how to claim health insurance and that you do not need to be intimidated by it. As we have already mentioned, following instructions and having the right documents in place is enough for you to get your reimbursed amount. The process might take some time, but you should have the approved amount in hand at the end. The important thing here is teaming up with the right insurance provider. If you have medical insurance from Tata AIG, the claim process is sure to go seamlessly, thanks to our network of claim service providers. So if you are looking for the right insurance provider, choose Tata AIG today!

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