When Should I Make A Health Insurance Claim?

Written by : Knowledge centre

2024-08-02

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Health insurance plan can be claimed if the policyholder is admitted to the hospital for at least 24 hours or dies in the hospital after 24 hours of admission. You can even make a health insurance claim if the policyholder dies due to an accident and medical illness. You can claim health insurance either through cashless or reimbursement mode. The health insurance claim limit ranges from Rs 1-5 lakh.

1. After how many days can we claim health insurance?

The initial waiting period is generally 30 days (minimum) to 90 days, and it can vary according to the policy. However, an exception can be made if the insured meets an accident and needs emergency hospitalization.

While in a disease-specific plan, the claiming period of coverage for a specific disease is a minimum of 1-2 years at all stages (early or advanced). The claiming period ranges from 1-4 years with continuous policy coverage in the pre-existing waiting period.

The duration for such a waiting period depends on the medical condition and the chosen insurer. The next type is maternity plans, in which the waiting period ranges from 9-36 months. However, most of them offer a 2-4 years waiting period, and it is always suggested to the customers to purchase the policy early.

2. How to claim health insurance policy?

a. Pre-Inform before you are admitted for planned hospitalization. In case of emergency hospitalization, inform your insurance company within 24 hrs.

b. Provide hospital documents, including receipts, prescriptions, discharge papers, bills and copies of the report to the insurer while submitting the claim

c. While filling the form to claim health insurance read all the guidelines carefully and follows the procedure accordingly.

d. Check all the insurance papers and make sure that the bank details are filled incorrectly.

e. Submit the form and required documents at the earliest to avoid any delay.

f. It takes up to 45 days maximum to claim to be completed. Until then, keep all the necessary documents prepared for additional requirements.