How to Reduce the Hassles of Filing a Health Insurance Claim?

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A medical emergency is a worrying situation for you and your family. To make your visit to the hospital stress-free, it is crucial that you are well-versed in the know-how of health insurance claims pertaining to your medical insurance. 

To start off, you must read and understand the terms and conditions of your health insurance policy before purchasing it. This will ensure that you choose a plan that entails the minimum hassle while filing a claim. 

You can also follow a few pointers to expedite the insurance claim process. Read about them below.

The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.

Points to consider to ease the health insurance claim process

Here are a few tips you can follow to reduce the hassles of health insurance claims:

  • Be transparent

While filling up your insurance form, remember to provide all the correct details and never hide any essential information. Additionally, consider double-checking to ensure that you have left no place for ambiguity. Finally, always mention your past and existing health issues and whether you drink or smoke.

Note that even the smallest of errors can cause disruptions when you approach your insurer for a claim.

  • Know all about your policy

 It is very crucial that you read the terms and conditions of your health insurance dubai plan entirely and in great detail. Try to read through the features, coverage benefits, inclusion and exclusions of your plan. Additionally, consider checking the rules pertaining to health insurance claims processing. This will help you stay informed regarding the claim-filing formalities. 

  • Update your policy regularly

Upon purchasing a policy, it is crucial to update it at regular intervals. This would ensure that your policy reflects essential details, such as an address, contact number, email and more. You should also keep proof of all modified details. This will help your insurer in contacting you directly. It will also ensure that you face minimum hassle while filing a claim for your health insurance policy.

  • Know the claim settlement process

Typically, almost all insurance companies follow a similar claim settlement process. First, however, you should confirm the formalities related to filing a claim and other essential requirements. If you are prepared in advance, you won’t have to face any last-minute hassle.

  • Keep all documents handy

Keep your policy documents in a safe and accessible place. Remember to submit such documents beforehand to fasten the claim settlement process when filing health insurance claims. Note that last-minute paperwork can cause unwanted delays. Further, if you miss any paper, it can make the entire process significantly lengthy. 

Even after following all the norms set by your insurer, if you face a claim rejection, you can move your concerns to the higher authorities. This might help you resolve the issue and get your dues.

Types of claims in health insurance plans

Typically, you can make an insurance claim through two methods. Both these methods have a distinct set of features. Consider choosing the one best suited for you:

  • Direct claim

Most insurance companies offer a direct claim settlement option. This means that you are not required to make any out-of-pocket expenses. Instead, the hospital will pay the needed medical costs directly. However, in the case of a direct settlement claim, the insurer specifies a list of network hospitals where this claim settlement process will work. Hence, you have to be admitted to those hospitals only.

  • Reimbursement claim

The second type of health insurance claim is the reimbursement claim method. In this case, you need to pay the medical bills from your pocket beforehand. Following this, you can visit your insurer to file a claim with the necessary documents. Again, this method eliminates the need to search for a network hospital. 

However, here are a few points you should remember regarding reimbursement claims:

  • You may require pre-authorisation in a few procedures. Without that, you will not receive any coverage benefits.
  • Certain hospitals may be excluded from reimbursement claims. Find out about them beforehand.
  • Sometimes, only a percentage of treatment/medical costs is covered for reimbursements.

At times, your reimbursement sum is not based on your actual medical costs. Instead, the insurer pays you for the general cost of treatment for that disease at clinics or hospitals in its own network.

Filing a Health Insurance Claim

To sum up, filing health insurance claims is not a challenging task if you hold the needed knowledge about your medical policy. However, the process is rigorous and involves various paperwork. Thus, the first step to experiencing a hassle-free claim settlement procedure is to keep patience. 

While you stay insured and your family is free from financial distress, following a few helpful tips on your part can ensure prompt and quick claim redressal. This will also help keep your policy in force and updated. Remember to keep your family members educated on the exact details so that they can trace them quickly during a situation of a medical emergency. 

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