How to File a Health Insurance Claim ?

    Saturday, November 13, 2021

    Do you have health insurance?  Always remember, study your policy carefully so that later if needed during a claim, you will understand how.

     There are two ways to submit a claim.  First, by providing a special insurance card for policyholders, known as a cashless card, which can be used in all hospitals that partner with the insurance company.  Show the cashless card to the officer during treatment and the cost will be borne by the insurance company.  The second is the reimbursement system, where the policy owner pays all medical expenses at the hospital in advance.  After that, you can fill out a special form from the insurance company to then submit a claim accompanied by supporting documents determined by the insurance company.

     Here are tips to help you gain knowledge about health insurance claims:

    1.Understand the health insurance benefits covered

     Before undergoing treatment, the policyholder is considered to have understood the health insurance benefits covered, the maximum limit and exceptions listed; the type of illness and the treatment facilities.  To get complete information, policy owners can ask the insurance company's Customer Service or insurance agents.

    2. Learn the requirements for submitting a claim

     Take note of what the requirements are to file a claim.  When you want to make a claim, the policy owner must fill out a claim form.  Find out how to get the form by visiting the insurance marketing office, customer service or downloading it from the insurance company's official website.

     3. Pay attention to the completeness of the documents for submitting a claim

     As a condition for submitting a claim form, you will usually be asked to complete supporting documents such as a doctor's certificate and proof of hospital payment.  Make sure what documents are needed by reading the requirements listed in the insurance policy.

     4. Submit a claim as soon as possible

     Insurance companies generally have an expiration date for filing claims.  To find out the expiration date can be seen in the insurance policy file.  It is recommended that the claim submission process be carried out as soon as possible after completing treatment or hospital treatment.  If the claim is submitted past the expiration date, the insurance company may refuse to disburse money to cover medical expenses while in hospital.