The purpose behind your buying a health insurance plan is that it should compensate you when the need arises. While in some cases, you may be able to enjoy the benefits of cashless hospitalisation, at other times, you may have to get the reimbursement later.
Reimbursement is usually done when the policyholder gets admitted in a hospital which is not in the insurer’s network, or when the hospital does not offer the cashless facility.
So, in the case of reimbursement, you as a policyholder need to pay all the dues to the hospital at the time of getting discharged. You then need to submit a claim to the insurer later, to receive the compensation against the expenses incurred.
However, intimation is an essential aspect of making a claim. Unless the insurer is intimated in time, chances of your request getting settled may reduce. Notably, in case of planned hospitalization, you need to intimate the insurance company about the forthcoming claim well in advance. But if it’s a case of emergency hospitalisation, then claim intimation needs to be sent to the insurer or TPA (Third Party Administrator) within 24 hours.
However, after you or your loved one has obtained the medical treatment and are getting discharged, there are various aspects to keep in mind, to claim health insurance later.
For your convenience, we have listed down five such crucial things that you must do at the time of discharge.
One of the first vital document that you need to procure from the hospital authorities is the discharge summary. This document shall specify all the essential details related to hospitalisation, starting from the patient’s name, age, diagnosis and further course of treatment required.
Serving as a good proof of all the vital specifications that insurers look for, in passing off and reimbursing the claim, you must obtain this and keep it safely with you until the claim is passed off.
During hospitalisation, you must have also paid a reasonable sum of money for the room rent, various medicines and injections required during the treatment and other administration charges. At every point, you must have got a cash memo or a bill of the expense incurred. So, before discharge, make sure that you keep all such bills, cash memos and receipts together with you at one place.
If you bought any medicines prescribed by the doctor, from a pharmacy outside the hospital, during such hospital stay, then request for a bill for the same too. At the time of filing the claim, you can attach a copy of all these bills to get reimbursement against such expenses also.
If you want speedy reimbursement, keep the health insurance claim form duly filled and ready, preferably before the discharge. Upon your discharge, you can attach all other relevant documents along, and then pass it to the insurer to request for reimbursement money.
At the time of discharge, you can also request your doctor concerned to issue you a medical certificate. The medical document will specify the reason for, and the number of days of your hospitalisation. The insurer can retrace through such evidence and proofs and establish the authenticity of your health insurance claim. So, if your doctor is not issuing you such a certificate on his own, then politely request him/her to grant you one for insurance claim sake.
In case, you get hospitalised after meeting with an accident, under emergency conditions, then ensure that before you get discharged, one of your closed ones gets an FIR filed in your name. In such a situation, the insurer will, in all probability require you to produce either the FIR slip or Medico-Legal Certificate. So, obtain these before you get discharged from the hospital.
Stay Insured, Stay Secure
You can only enjoy reimbursement or cashless hospitalisation if you have a health insurance plan in the first place. In today’s day and age, when medical care and treatment costs are skyrocketing, it is crucial to have someone who can have your back. Moreover, given the rising incidence of lifestyle diseases and accidents, it is imperative that you consider having a health insurance plan to keep your loved ones and yourself secure even in the wake of unexpected challenges that may come your way.
Health Insurance policy, as offered by Bharti AXA covers pre and post-hospitalisation up to 60 and 90 days and provides comprehensive health coverage starting at Rs. 14/day. Moreover, you can also avail benefits such as no capping on room rent and annual health check-ups if you buy Smart Super Health Insurance Plan.
So, buy the right health insurance cover, and bear in mind all the essential documents you’ll need before making a claim.