We all may have heard some common cases where a claim for health insurance might have been delayed. There are many reasons why a claim could be delayed. We here will observe a few of them and will try to understand the process of filing a claim.
Health insurance plays a critical role in all our lives. Diseases are increasing at a faster pace than ever, much of this could be blamed at unhealthy living conditions and lifestyle. If we look at COVID-19 alone, the global parameters have changed completely. People now understand the importance of having health insurance for times of crisis. Once you get the policy, it is the responsibility of the insurer to cover the financial needs of you and your family. To ensure an easy claim settlement process, you must check the document. Let's take a look at some ways why a
health insurance claim could be delayed.
Not filing a claim in time:
One of the main reasons why claim settlements delay is because policyholders are not able to submit a claim on time. Every policy has a deadline in its term and conditions under which the claim should be filed. It may differ between insurance providers, but generally, it is 7 to 14 days. Thus, it is vital to take time out of your day and get the claim proves done within the deadline to avoid any delay.
Losing Insurance papers:
Papers are a vital part of the policy. Loss of the same can result in a delay in the claim process. Everyone with a plan must keep a backup of the original document on their computers and must also retain some photocopies of the same. If the papers are lost, the time taken to file the claim will increase.
Not following the right process:
In case there is any pre-medical treatment, it is advisable to apply for cashless treatment. The cashless claim settlement process would be more manageable at the later stage and would also unburden any monetary tension from your head. It will save all the hassle that a policyholder face at the end of the policy. The pre-authorization process for cashless treatment goes as follows:Procuring pre-authorization from your insurance companyFilling accurate patient and policy detailsThe doctor needs to fill in all the details regarding hospitalizationThe estimated cost of the procedure must be sent from the doctor's end to the insurerThen pre-authorization has to be sent to the insurer with all the necessary records
Exchange of Documents between Hospital and Insurance Company
Even though the pre-authorization process is simple, there could be some delay in the claim process due to settlement issues between the hospital and health insurance company. The hospital may delay sending the discharge report to the insurer. There is a delay in providing the bills. The faster the bill arrives. The quicker will be the process of filing the claim.
Other reasons could be a failure in procuring the right documents. Failure to note the exact time of hospitalization or discharge.
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