4 simple steps to file a Mediclaim in India

by Kiran Jhaa Finance

A Mediclaim is a health insurance policy that covers the medical expenses of the person claiming it to the sum assured in case of a medical emergency. However, filing Mediclaim insurance in India can be a tedious task. Most people fail to avail all the advantages that their Mediclaim policy offers due to two common reasons. One is the lack of awareness and the other is the inability to complete the required paperwork properly. The claim work is a complicated process. But if given proper guidelines it can be made easier. Here are 4 simple steps to guide you on filing a Mediclaim in India.

1. Place all the paperwork in order

Maintain a folder. Keep all the medical reports, lab/ diagnostic bills, receipts, etc. arranged in chronological order, as you will need them to submit to the insurer. Make sure you double check all the documents and that they contain all the necessary information. For example, the patient's name, serial number, document number, cost price, the signature of the authorised person and so on.

2. Ask for the claim form

Ask your insurance company for the claim form. It can also be downloaded from the company’s website. Make sure you read all the instructions given on the form and fill in all the details. Be careful when filling the information. After you are done filling the details, get the form signed by the policyholder and consultant treating the patient. A proper seal of the hospital should be stamped on the form too.

Attach all the medical documents such as the discharge summary, all papers related to the patient’s illness and treatment, the bills, etc. and also the policy documents which include the details of the previous policies, the starting date of the policy cover document, and the Third-Party Administrator (TPA) card, to the form.

3. Make copies of the original documents

Prepare copies of all the original paperwork. Both the original documents and their copies are required to be submitted along with the claim form to the insurer. Submission of only copies would not help in filing the claim. Attach all the documents in chronological order. Make sure none of the documents go missing, or otherwise the claim might not pass through.

4. Submission of documents

Make sure you submit the documents with the right TPA (Third-Party Administrator). You will get the name of the TPA from your insurance company. Visit the TPA branch and get your documents checked with a TPA executive and then hand over to them. Send a set of copies of all your documents to the insurance company, informing them that you have submitted your documents to the TPA.

Filing a Mediclaim can be a complicated job. Going through the stress of having your loved one hospitalised and then this tedious process can be exhausting. But if planned and followed these instructions carefully, you can claim your Mediclaim policy with ease.