Guidelines for Successful Health Insurance Claim

Successful Health Insurance Claim

Sometimes, people avoid buying health insurance online because they feel that the claim process is very difficult to complete. In fact, the majority of mediclaim policyholders look tense when they need to reimburse their claims.

Insurance companies in India on a regular basis come across numerous identical complaints regarding the ‘complexity’ experienced by buyers while filing a claim from the insurer.

There are some genuinely difficult cases; several unfortunate scenarios arise because some customers do not understand the value of correct details provided to the insurance company in India while purchasing the health insurance policy online or a failure to fulfill the duties which are expected of the policyholder.

In some cases, hospitalization claims are valid, but policyholders had not submitted the necessary documents to the authority concerned, the reimbursement procedure got delayed further. Therefore, the basic understanding of the healthcare plan is always essential for an easy claim settlement.

Below is a check-list on the do’s and don’ts that will make health insurance claim settlement procedure hassle-free.


  • If policyholder opts for cashless hospitalization, then intimate the insurance company in India prior to getting admitted in case planned hospitalization. Contact your insurer within 24 hours of the hospitalization if there is an emergency.

  • Submit all the necessary documents if the person is not admitted to a network hospital and still want a reimbursement.

  • Give the right details while submitting a claim settlement application. Share all important details pertinent to the subject matter of the online health insurance policy with the insurer in case of pre-existing diseases at the time of proposal. It may increase the premium amount slightly, but make sure that your claim is not repudiated.


  • Fraud claims may lead to advantages being forfeited or cancellation of the insurance plan. In future, no insurer would interest to offer coverage to someone who perceived as dishonest.

  • Repeated and small-budget claims will increase premium and eventually, claims start to get disapproved.

  • Delay in intimating is the loss to the insurance service provider and it may work against the policyholder. Hence, furnish the required documents to file a claim which should be approved easily.

Following the above-mentioned guidelines can ensure that the insurance company in India can efficiently process the health insurance claim India and the claimant will receive payment as quickly as possible.

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