Knowledge Centre

Quick Guide: Steps to Make Insurance Claim for Coronavirus

Currently,the coronavirus pandemic is affecting all aspects of life,worldwide. And the scenario is no different in India. Thousands are contracting this novel virus on a daily basis. Naturally,it helps to know the right way of approaching the Coronavirus insurance claim.

COVID-19 is an uncharted territory for all policyholders as well as insurance providers. Hence,the rules for filing a claim are not exactly the same as regular plans.

  • A basic indemnity health insurance plan will cover hospitalization expenses due to Coronavirus. - including pre-hospitalization as well as post-hospitalization charges

How does one register for coronavirus insurance claim?

There are different ways of claiming the COVID insurance. You can either go for cashless claims or the reimbursement process. Both processes have their pros and cons,but both can be availed when someone is filing for their coronavirus insurance claim.

Reimbursement claims

If you are able to pay the hospital bills upfront,then you can seek reimbursement claims where it is mandatory to fill in the claims form,and attach a list of documents like bills,discharge summaries and so on. You are also required to fill in your acknowledgement number,which is given by the hospital,for the form.

On the other hand,you can also upload your documents online on the insurance provider’s website,where they are scrutinized by the authorities,before processing the amount. Online uploads are now being favored and the TPAs are being encouraged to process the amount (if the documentation comes through) as soon as possible. An insurance clearance form or a cancelled check is adequate for instructing your insurance provider to deposit the amount in your account.

Cashless claims

These are often favored due to their lack of hassle and smooth processing,which just involves the hospital and the insurance provider. In order to go for a cashless claim,you can simply call the respective insurance customer care and register your claim by keying in your customer id and details of the hospital. You have to ensure that you are seeking treatment at a network hospital for the claim to work.

Once registered,the insurance provider contacts the hospital and the latter sends the required documents to the office,where the insurance authorities scrutinize the bills and other relevant papers before processing the amount. If the bill amount is more than the coverage amount,then the patient is required to pay the hospital directly,out of his/her own pocket.

The Insurance Regulatory and Development Authority of India (IRDAI) stated that insurance providers have to assess and decide on the authorization in case of cashless claims made by hospitals within two hours of the receipt of the claim request. Since corona care falls under critical care,this decision can work in the favor of the patient as well as the hospital.

Conclusion

Having insurance during these times of crisis is an important step to avoid the financial burden that can come along with the coronavirus treatment. For insurance claim (coronavirus),going cashless or opting for reimbursement depends on your choice and circumstances. But make sure that all your documents are in place to avoid future hassles.Stay safe,stay home,stay healthy.

Disclaimer: The above information is for illustrative purpose only. For more details,please refer to policy wordings and prospectus before concluding the sales.

Diwaker Asthana Health Insurance industry experience of 20 years

Diwaker Asthana recommends buying my:health Suraksha Insurance to get the benefit of a wide range of coverage that the plan offers. For some unique benefits like cashless home health care and in-patient treatment for mental illness,he believes this plan will benefit customers in the long run.


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