How to ace an Insurance claim process without worrying about the possible outcomes

  • postauthorRaj
  • postdateFebruary 7, 2024
  • postreadtime3 min read
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The result of a claims application is often a cause for worry for people. But we’re here to enlighten you and simplify the insurance claim process. The process can be a little daunting, but we are here to make your life as easy as we can. As a health tech company, our superpower is to influence you to adopt our simple steps for digitized insurance claim process.  

Initially, there was a delay in the claim settlement process through traditional insurance claim processes. But at Onsurity, our digitization process outweighs the traditional delay of claims settlement by ensuring that our customers can process their claims in just a few clicks.   

Since the COVID outbreak, digital engagement with our customers has been much simpler and more efficient thus simplifying claims. However, with the rising number claims it is essential for us to guide you on the outcomes of the claims applied. 

There are the two outcomes of an insurance claim process  

Approval  

When you provide all the necessary documents and information correctly, your request gets approved. 

Rejection 

Following are the possible reasons of rejection of claim from an insurance provider’s end: 

  • Hospitalization expenses are in exclusions of policy conditions 
  • When the treatment doesn’t have an active line of management  
  • Hospitalization is done beyond the needs of medical care  
  • When the hospitalization claim is from blacklisted hospitals 
  • The ailment limit or sum insured is exhausted 
  • When the claim is proved fraudulent 

Here are some few tips to consider while applying for an Insurance claim process in India to get an easy approval: 

Do not delay notifying your claim 

By notifying your claim based on the stipulated time you can seek an early verification of the claim. The notification of claim depends on if the claim is planned or cashless. Be mindful of the nature of the claim while seeking approval. 

Familiarize yourself and stay updated with the policy details 

There are various updates regarding the changing of partners, change in the technology of the process, additional benefits, expansion of network providers, etc. Users will receive updates on transitions and changes through email.

Document verification for insurance claim process

While applying for a claim on our app, the screens automatically direct you to the required documents. It is important to verify these documents with the original bills, payment receipts and diagnostic reports. 

Don’t file if you have other claims 

There are high chances of rejections if you apply for a claim while you have an ongoing claim. Factors such as limits, coverage, etc. influence claims and their verification. Hence, we recommend you to prioritize one claim at a time.

Keep a check on your limits 

 Limits are extremely crucial while verifying claims. The policies are usually transparent enough on the extent of the coverage and as per the illness, the amount that can be covered. You can leverage the allotted limits for emergency hospitalization as well. 

Keep your e-documents ready for insurance claim process

You can never be over-prepared, there is usually some or the other documentation required while filing for a claim. Hence, we recommend you have a soft copy of all your documents, to prevent extensive documentation.  

Maintaining e-documents makes access easier and helps maintain a digital version of documents applied for a certain claim. 

Claim settlement process 

 The final step in the insurance claim process claims settlement. Based on the nature of the claim, every claim has a stipulated period. These stipulated periods are dependent on various factors such as the final authority of the insurance teams and mode of transfer etc. Hence, track these claim process through application, because any disruptions can be handled during the process of claim settlement.  

In case you have further questions on how to file claims Onsurity is here to help you. We have a dedicated claims assistance team known as “Good Doctor Team” who help you with easier authentication of the claim process and understand and handle your request in an efficient manner. 

Onsurity is dedicated to providing Startups and MSME’s with complete Employee Healthcare services at an affordable plans.

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