3 Things to know, for easy Insurance Claim Settlement


3 min read
11 Apr
11Apr

Getting your claims settled is the ultimate purpose of having an insurance. Here are three things that you should do or know to get the claims settled when in time of need.

1. Understand your health insurance plan waiting periods

Generally 3 kinds of waiting-periods are applicable for Health Insurance plans in India.  These are;a) 30 Days Initial Waiting period (for Any Illness)

Is applicable for every Health Insurance policies in India. Out of which the first 15 days is a Free-look-period, when you can drop and get back your paid premium even. 
This waiting is not Applicable for accidents, in which case the coverage is from day 1. Also in case of some specific plans like Energy Plan if HDFC Ergo where the plan covers every illness from Day 1.

b) 2 years compulsory waiting period (for Specific Illness )

There is a very specific list of 20+ illness conditions, which can  wait for a treatment. Or you can say, it may not get worse in an year or two and reach a stage of emergency medical care. Cataract, Arthritis, Fistula etc are some examples. full list here.

c) 3 or 4 years temporary waiting period (for Existing Illness)

This is also known as  PED  (Pre Existing Disease) waiting period


2. Read your Insurance exclusions 


Each insurance product is different and is not meant to cover any and every medical needs of a person. Especially in India, Health Insurance means to cover unexpected medical expenses. So, what about the expected medical conditions and the existing ones? 
So carefully read the exclusion part of your policy wording. A Policy wording  is more like a complete legal manual for your Health Insurance plan. And every insurance company is supposed to abide by this document which serving you. If you don't have one yet, ask your insurance advisor. Or download it from your insurance providers website & read the section named, Exclusions.

3. Identify your nearest Network Hospitals


A network hospital is one which has agreed to your Insurance provider's payment terms.  When you visit a network hospital your claim settlement process is hassle free. So identify the network hospitals in your locality for any treatments. Make sure to keep your family members aware of this list, in case of emergencies.

These points can also help you choose the right health insurance plan for your family. Don't worry, if you missed it during the first time, you can always port your current insurance to a better plan. But this time make sure to consult a sensible insurance advisor. With the right personal insurance advisor on your side, claim settlements are even easier. It gives a rare peace of mind knowing that your savings account or rainy day fund is still intact. 
For more details feel free to contact our consulting advisor; Abhijith Vijay | Mob. 9846233161

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