FAQ's

FAQ

  • What is insurance coverage?

    Health insurance coverage is a particular medical expense for person(s) who is/are covered under the issued policy. Knowing your insurance helps you claim what is rightfully yours. Make sure you are well aware of your health insurance plan and understand all the rightful benefits.

  • How does medical history affect my insurance?

    Health insurance claims are denied if hospitalization is due to undisclosed medical history. Learn about it from an expert!

  • Is my pre-existing illness covered in my insurance?

    A pre-existing illness can be covered if an individual was unaware while buying the policy. Know more from our experts!

  • Will my lifestyle risk a smooth claim settlement?

    Food habits and lifestyle have less to do with claim process and more with your monthly insurance premiums when a serious illness is diagnosed. Understand the process with an expert!

  • Does my insurance offer OPD expenses coverage?

    Certain health insurance plans offer OPD cover and assist the insured to claim expenses other than those incurred during hospitalization. Tell us about your insurance to know whether it offers the same.

  • Are OPD expenses covered without admission?

    Many insurers offer health insurance policies with coverage for OPD expenses such as medical bills, diagnostic tests, ambulance charges, health checkups, dental treatments, etc. Ask an expert to learn what your insurance covers.

  • How to know what treatment my insurance covers?

    Simple! Log in and talk to a ClaimTherapist expert, share your insurance details and we will guide you. Chat with an expert now!

  • How to file a claim?

    From claim intimation to claim submission, filing your medical claim includes multiple steps. You do not want to miss a single step as it may raise a query on your claim. It’s important to learn and understand all the steps and their significance. Consult with an expert to learn more.

  • How to fill a claim form?

    Stuck with a section in your medical claim form? Keep a ClaimTherapist sample form handy. Read the form properly. Take help from someone who is experienced in filing a claim. You can also ask ClaimTherapist experts, as always.

  • Where to upload my documents online?

    We offer free self-claim submission online. Go to Prepare Claim Yourself section and login to ClaimTherapist platform and follow the step-by-step paperwork guidelines.

  • I'm not sure where to start from.

    Start with a proper study of your insurance policy, what it covers and what it doesn't. Check the documents and bills needed. Then go to Prepare Claim Yourself section and login to ClaimTherapist platform and follow the step-by-step paperwork guidelines.

  • I delayed my claim submission. What's next?

    Don’t worry if you delayed submitting your claim. If you can provide a valid justification for the delay in claim submission, your insurer/TPA accepts your claim. Consult with a claim expert if you still have doubts.

  • What documents are required in reimbursement claim?
    1. Duly filled claim form (Intimation to toll-free number is mandatory before the form is filled).
    2. Original bills/receipts and discharge certificate/card from the hospital.
    3. Original bills from chemists supported by proper original prescription.
    4. Receipt and investigation test reports from a pathologist supported by the note from attending medical practitioner/ surgeon prescribing the test.
    5. Nature of operation performed and surgeon's bill and receipt.
    6. Self-declaration/MLC/FIR in case of accident cases.
    7. Treating doctor's certificate.
  • What documents are required in cashless claim?
    1. Duly filled claim form.
    2. Doctor's consultation papers.
    3. Investigation reports (e.g. X-ray, scans, blood report, etc.)
    4. Pharmacy invoices supported by respective prescriptions.
    5. In cases of accidents, Medico Legal Certificate (MLC) and / or FIR.
    6. Discharge summary.
    7. Other relevant document.
  • What you should know about claim denial!

    There are several reasons insurance companies deny claims for. While some reasons might be valid and can’t be avoided, few reasons can be disputed. Make sure you don’t get overwhelmed or emotionally driven by a claim rejection and take the right step by consulting with an expert like ClaimTherapist.

  • Why my medical claim got rejected?

    There can be various reasons behind claim denial (e.g. the treatment is not covered under your policy, your sum insured got exhausted etc.). Claim can also get rejected because of your pre-existing medical history. Learn more with ClaimTheapist now.

  • Is there any possibility to reclaim my health insurance after rejection?

    Claim rejection by insurance is not the end of the road. Even insurer/TPA can make a mistake while processing the claim. If you feel claim rejection is not valid, you can dispute and request them to reconsider the claim with your justification and medical facts. Ask us to learn more.

  • Health insurance claim got denied. How to dispute?

    If a claim is denied, the first thing you need to do is to request your insurer/TPA to reconsider the claim. If you are not satisfied with the outcome, you need to lodge a complaint with Grievance of the insurance company. If the dispute is not working out, you can further complaint to Ombudsman. Talk to an expert if you need more suggestions.