When making a claim against a health insurance policy, the following documents are typically required:
- Claim form: A duly filled and signed claim form provided by the insurance company.
- Original bills: Original invoices and bills from hospitals or healthcare providers.
- Medical reports: Reports detailing the diagnosis, treatment, and prognosis.
- Prescriptions: Prescriptions for medications or treatments recommended by doctors.
- Discharge summary: A summary of treatment and condition at the time of discharge from the hospital.
- Investigation reports: Reports of diagnostic tests or procedures undergone during treatment.
- Identity proof: Any valid identification document for verification purposes.
Documents required for cashless treatments
For availing cashless treatments at network hospitals, the following documents are necessary:
- Health insurance card: A health insurance card issued by the insurer with policy details.
- Hospital pre-authorisation form: A form requesting pre-authorisation for cashless treatment.
- Identity proof: Any valid identification document for verification.
- Treatment estimate: An estimate of treatment costs provided by the hospital.
- Doctor's prescription: A prescription from the treating doctor recommending the necessary treatment.
Things to keep in mind when buying health insurance
With the rising cost of healthcare in India, buying a health insurance policy has become essential. However, with so many options available, selecting the right plan can feel overwhelming.
Here are a few important factors to consider when choosing the best health insurance policy to safeguard your family’s well-being:
1. Adequate sum insured
Ensure your plan offers a sufficient coverage amount to meet your healthcare needs. If you or a family member has pre-existing conditions, opt for a higher sum insured. Also, account for future medical inflation—what seems adequate today may fall short a few years down the line.
2. Balanced premium vs. coverage
Premiums vary across insurers even for similar benefits. While it may be tempting to go with the lowest premium, ensure that the policy still offers comprehensive coverage. The ideal plan balances affordability with key benefits—avoid sacrificing essential coverage just to save on premium costs.
3. Wide network of hospitals
A strong network of hospitals is crucial for availing cashless treatments. Choose a policy that includes a wide list of reputed network hospitals across India. This ensures you or your family members can access quality care without financial stress during emergencies.
4. Easy and transparent claim process
An insurer’s claim settlement process should be smooth, quick, and hassle-free. Read customer reviews, compare claim settlement ratios, and understand the documents required. Opt for a provider known for seamless claim handling and supportive customer service.
Taking these aspects into account will help you choose a policy that not only fits your budget but also supports you when it matters the most.
How to file a health insurance claim: Step-by-step guide
Filing a health insurance claim can often seem overwhelming, especially if you’re unfamiliar with the required documents. To make the process smoother, follow these essential steps:
Step 1: Collect and organise all medical documents
Gather all the necessary paperwork such as medical bills, payment receipts, prescriptions, test reports, and hospital discharge summaries. Organise them in chronological order for easy reference. Ensure every document clearly mentions the patient’s name, date, hospital details, treatment costs, and signatures wherever required.
Step 2: Fill out the claim form accurately
Download the claim form from your insurance provider’s official website. Read the guidelines carefully and fill in all the details correctly. Once completed, attach the form with your compiled set of medical documents and bills.
Step 3: Submit original and photocopies
You’ll need to submit both original documents and photocopies, as per your insurer’s requirements. Keep a full set of copies for your personal records in case of future queries or disputes.
Step 4: Double-check before submission
Before submitting, review all documents thoroughly. Missing papers or incorrect details can delay or even lead to claim rejection. Ensure everything is accurate and complete for a hassle-free process.
By following these steps and keeping a checklist of required documents ready, you can increase the chances of a smooth and timely claim settlement.
Common mistakes to avoid when submitting health insurance claim documents
To ensure your health insurance claim is processed smoothly and without delay, avoid these common errors while submitting documents:
1. Submitting incomplete or incorrect documents
One of the biggest mistakes is providing incomplete or inaccurate information. Always verify the list of documents required for your specific insurance plan and ensure the claim form is properly filled out and supported with all necessary documents for faster processing.
2. Mismatched address or personal details
Ensure that your personal details—such as name, address, and date of birth—match across all submitted documents, including the claim form, medical reports, and KYC papers. Any mismatch can raise queries and delay the claim.
3. Missing mandatory medical reports
Each health insurance policy may require specific medical reports based on the treatment. Failing to include these critical documents can lead to claim denial or unnecessary delays. Always cross-check what reports are needed before submission.
4. Ignoring insurer-specific guidelines
Different insurers may have unique requirements when it comes to claim documentation. Not following these specific submission guidelines can result in missed documents or format issues, affecting your claim approval timeline.
5. Submitting outdated or invalid KYC documents
Ensure that your identity, age, and address proofs are current and valid. Expired or outdated KYC documents may cause unnecessary verification delays or claim rejections. Update your KYC details before submitting them.
6. Skipping income proof for tax exemptions
If you're claiming tax benefits under your health insurance plan, don’t forget to submit valid income proof such as recent salary slips or your latest Income Tax Return (ITR). Missing these can impact your eligibility for tax deductions or slow down the claim process.
How to buy health insurance offered through Bajaj Finance?
Follow the steps given below to buy a health insurance policy offered through Bajaj Finance:
- Step 1: Open the online application form by clicking on ‘Get Quote.’
- Step 2: Fill out the application form with necessary details, including name, gender, mobile number, date of birth, and residential PIN code.
- Step 3: Click on 'Get Quote' to proceed.
- Step 4: Choose your preferred Health Insurance plan from the list shown, then click 'Buy Now'. You can customize the insured amount, policy term, and plan-type.
- Step 5: Select the health policy term and premium amount based on your chosen plan.
- Step 6: Verify your email ID and ensure all personal details are correct. Click 'Next' to proceed.
- Step 7: Provide additional details such as height, weight, nationality, marital status, address, and nominee details if applicable.
- Step 8: Answer health and lifestyle questions by selecting the relevant checkboxes, then click 'Next'.
- Step 9: Review all filled details for accuracy and click 'Proceed' to visit the payment page.
- Step 10: Make the payment through net banking, UPI, debit, or credit card to complete the purchase of your policy.
Health insurance is an essential aspect of financial planning to meet medical emergencies. It is important to have all the necessary documents in place and regularly updated. Make sure to go through the list of documents required for health insurance before purchasing any policy. By keeping these documents ready, you avoid any unnecessary delays in the claim process. Therefore, secure your health and finances by getting your health insurance documents ready on time.