Page 345 - Ebook health insurance IC27

Sashi Publications

submitted along with the claim form. At the time of submitting the claim form he must
obtain an acknowledgment from the insurance company about the receipt of the
documents to serve as a proof of submission.
14. The policyholder must followup with the insurance company about the status of the
claim after some time as the insurance company may require some other documents
or clarifications from the hospital about the charges.
15. The insurance company if finds everything in order shall make payment for the
claim. Many times it deducts some amounts from the bill which are not authorized
under the policy or which may seem to be in excess.

Important DO's and Don'ts

1. Always keep the health ID card and related policy documents in a safe place and
make sure that all the family members must know about it.

2. Fill the claim form very carefully. Any wrong information ignorantly may lead to
rejection of claim or reduction in claim amount

3. Keep the number of TPA in a prominent place so that you can contact them easily
and immediately.

4. Take your health card and list of network hospitals along with you while you travel.
You may have medical emergency at any place.

5. Don't forget to lodge a FIR in case of an accident
6. While getting admitted into a non network hospital check that it fulfills the required

criteria. Generallyahospital/nursing homemusthave15 in-patient beds,fully equipped
operation theatre, fully qualified staff.
7. Many claims are rejected due to pre-existing disease whether known or unknown
to insured. Be careful while giving details to your consulting doctor about your

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