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While cashless hospitalization is the most convenient, it may not always be possible to find a nearby network hospital affiliated with your insurer, especially in case of a medical emergency. However, you can always file for reimbursement from your insurer after bearing the medical costs. This blog helps you understand the exact process to fill a health insurance reimbursement form.
The best part about getting health insurance for you and your loved ones is that you never have to worry about bearing the financial burden of healthcare costs in case of emergencies. And to make the process even more smooth for you is the exclusive advantage of cashless hospitalization provided by most insurers. This facility can be availed at any of the network hospitals near you, which is provided by your insurance company.
However, it cannot be ignored that medical emergencies can come in uncalled for anytime, anywhere. What if you don’t have access to one of your insurer’s network hospitals at that time? Treatment cannot wait and so you’d need to avail whatever best you have at your disposal at the time. Your insurance company would, however, reimburse the costs borne by you at a non-network hospital up to the limit covered by your insurance plan.
For this, your insurer would ask you to simply fill out a health insurance reimbursement form, a simple document with all the details of your treatment and the costs borne therewith. Read on to know more about this form and how exactly to fill it out in case you ever have to.
As stated above, your insurance company may require you to fill out a reimbursement form in case you did not avail of cashless hospitalization at one of the network hospitals of the insurer. This form is generally handed over to the patient after they have been discharged from the hospital. The patient must submit this claim reimbursement form, along with the other relevant documents, to their insurance company within 15 days of being recharged, after which the company may not entertain your reimbursement claim request.
Here’s how you can complete your claim reimbursement form easily and without making any mistakes:
You would need to submit the relevant details such as the policy number, your name and contact details.
This would include filling out the insurance company’s name under which the patient is covered, the policy number of that health insurance plan, and the total sum insured under that plan. Besides, you may also need to furnish details about prior hospitalization history, if any, and any prior record of insurance coverage for the hospitalization.
You would need to fill out the name of the insured, their relationship with the primary insured person under the policy, their contact details, and their occupation.
You’d be required to collect all original reports for the treatment from the hospital, right from the date of admission until the date of filing the claim. You’d also need all original receipts of hospital bills for all tests conducted as well as pharmacy bills. In case you have any receipts of lump sum cash benefit received from the insurer, attach those as well along with the other documents.
The claim amount would need to be computed based on the pre-hospitalization costs incurred, the expenses borne during the hospitalization of the insured patient, the post-hospitalization costs incurred for the patient, as well as any other costs involving use of ambulance or any health check-ups performed (if applicable).
The insurer would require you to provide your bank name and branch, bank account number, IFSC code, PAN details, and Cheque/DD details.
Make sure to look through the entire form again once you have completed filling it. At the end, the insured would need to provide their signature and mention the date of filing the claim. Also ensure that Part-B of the form (as described in the above section) has been duly filled in by the hospital.
The health insurance claim reimbursement form is long and may require several details to be furnished. However, these details are required by the insurer in order to process your claim successfully. Make sure to provide all accurate and complete information in the form. In case of any doubt, do not hesitate to get in touch with your insurance company. For the best health insurance plans, check up online and read all the policy documents carefully before selecting one for your requirement.
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