Pointers to keep in mind when you are about to make a health insurance claim.

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Key Takeaways

  • Prioritize understanding waiting periods, including pre-existing and initial waiting periods.
  • Familiarize yourself with policy inclusions and exclusions for efficient claim settlement.
  • Pay attention to policy terms, sub-limits, and co-payment clauses to avoid complications.
  • Note that a minimum 24-hour hospitalization is required for most claims.
  • Verify the network of hospitals and update contact details for smooth settlements.

Health insurance claim: India has witnessed a surge in the number of people opting for health insurance. A lot has got to do with the importance of health insurance ever than before. Health insurance is required to be claimed as and when needed. You can look for the best mediclaim policy in Hindi that would provide instant rewards on all counts. But all the health insurance policies are not well versed with the protocol of health insurance. Since claim settlement assumes considerable importance when it comes to health insurance, there are a few pointers you need to consider before you plan to file a health insurance claim.

What is Health insurance claim: Waiting period

The waiting period is a time frame during which no claims are admissible.  It may be a waiting period for pre-existing diseases, an initial waiting period or one for a specific type of disease.

The inclusions and exclusions

To avoid any confusion during the claim settlement, you need to be aware of the inclusions and exclusions of a health insurance policy.  It enables you to save time in the future to deal with things in a better way.

Terms along with conditions

Being aware of the inclusions along with exclusions is not enough. It would help if you were mindful of other pointers like sub-limits, co-payment clauses. Suppose you do not comply with the terms along with conditions at the time of making a claim. If you are not following the words along with conditions when making a claim, there is a strong possibility that your lawsuit will eject.

Minimum hospitalization

If you are not aware, then a minimum of 24 hours hospitalization would be necessary to avail the benefits of a health insurance policy. However, there is a specific type of daycare procedure that will not require full-time hospitalization. An example would be chemotherapy. So, if you head to a hospital and opt for a tetanus injection, then you should not be claiming for it.

Cash settlement has a vital role to play when it comes to healthcare insurance. So, when you are purchasing a health insurance policy for yourself and your loved ones, it is not only necessary to be considering factors like exclusions, coverage, or the time of the procedure. Even the claim settlement process that an insurance company offers holds a lot of relevance.

Network of hospitals

Every company that is offering health insurance plans has tie-ups with a network of various hospitals. In the case of any emergency, you need to check out the list of hospitals listed in your region. Even it is going to prevent any form of confusion at the time of settlement. The list of hospitals is mainly found in the policy document, and if the need arises, you may get in touch with the customer care department.

Tips to keep in mind to ensure a smooth claim settlement process

When investing in a health insurance policy, a policyholder mustn’t lie about their habits like drinking, smoking etc. It will make the policyholders less stressed and would prevent any form of inconvenience at the time of settlement.

During the purchase of a policy, understand every point in detail so that there is no issue in the claim settlement process. People often go through the terms and conditions of the policy but fail to study them in detail. Understanding the exclusions or inclusions are essential. It is going to provide a fair idea during the claim settlement process.

After investing in a health insurance plan, you need regular updates about the contact details of the policy. For example, when changes are made, you need to update your address or other numbers. If you are updating your information, it will lead to a hassle-free settlement when a medical emergency arrives.

When purchase a health insurance policy, keep all the documents handy at the time of settlement. Care insurance provides a comprehensive health insurance policy that is going to take care of all your requirements. So, opt for their policy on all counts. Health insurance claim, Health insurance claim, Health insurance claim.

Read also: Benefits of Arandanos to Health.


  • Sehrish Kiran

    With years of experience in research and writing, I have honed my skills to provide valuable insights and captivating content. My journey through different fields and topics has equipped me with a well-rounded perspective that enriches my articles.

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