How to Claim Health Inusrance
People in India know how to insure themselves, but dont have much knowledge HOW TO CLAIM, this blog gives you the gist how to claim Health Insurance,
LICs Health Insurance Claim Process :
On hospitalization & / or surgery, policyholder is to submit the following:
1. Hospital discharge summary, giving time and date of admission and discharge from the hospital/ ICU.
2. Hospital treatment form completed & signed by the hospital authorities along with health card / photo identity card photo copy on this HTC form
3. Claim form duly completed & signed
4. Final bill of expenses from the Hospital
Attested copies of the above requirements are to be submitted at any office of LIC or to TPA within 30 days of discharge from the hospital. If beyond 30 days, BMs are requested to get this waived from SDM, who has the authority to waive delayed submission of claims.
The claims submitted have to be sent to the servicing TPA of your Division. On receipt of claim forms, within a week, TPA writes to the policyholder informing him of requirements, if any. Else the claim is processed and sent to HI, CO, Hyderabad for claim decision :In case of non receipt of requirements the TPA sends 3 reminders every 10 days. The claim is held for 90 days at TPA for receiving the requirements. After 90 days if the requirements are still not received the claims is rejected for want of requirements.
Even at this stage the Division can review the claim, follow up with the policyholder, with the help of agent and development officer, for submission of requirements. The soft copies of claim forms are available on our HI, CO website “Health Express”. Every Division to have a link to these Claim forms so that Branches can print them. To be freely available to Agents & policyholders.
To help 1700 policyholders whose Claims are pending for requirements, LIC have launched a special campaign. A window is opened till 30.6.11. Mgr HI is to review Claims pending/ rejected for requirement till 30.4.11. Available on site & we’ve written to Mgrs HI. The Branch HI Mentor, BHIM/ Nodal Officer is to follow up with the policyholder for submission of requirements by y 30.6.11.
People in India know how to insure themselves, but dont have much knowledge HOW TO CLAIM, this blog gives you the gist how to claim Health Insurance,
LICs Health Insurance Claim Process :
On hospitalization & / or surgery, policyholder is to submit the following:
1. Hospital discharge summary, giving time and date of admission and discharge from the hospital/ ICU.
2. Hospital treatment form completed & signed by the hospital authorities along with health card / photo identity card photo copy on this HTC form
3. Claim form duly completed & signed
4. Final bill of expenses from the Hospital
Attested copies of the above requirements are to be submitted at any office of LIC or to TPA within 30 days of discharge from the hospital. If beyond 30 days, BMs are requested to get this waived from SDM, who has the authority to waive delayed submission of claims.
The claims submitted have to be sent to the servicing TPA of your Division. On receipt of claim forms, within a week, TPA writes to the policyholder informing him of requirements, if any. Else the claim is processed and sent to HI, CO, Hyderabad for claim decision :In case of non receipt of requirements the TPA sends 3 reminders every 10 days. The claim is held for 90 days at TPA for receiving the requirements. After 90 days if the requirements are still not received the claims is rejected for want of requirements.
Even at this stage the Division can review the claim, follow up with the policyholder, with the help of agent and development officer, for submission of requirements. The soft copies of claim forms are available on our HI, CO website “Health Express”. Every Division to have a link to these Claim forms so that Branches can print them. To be freely available to Agents & policyholders.
To help 1700 policyholders whose Claims are pending for requirements, LIC have launched a special campaign. A window is opened till 30.6.11. Mgr HI is to review Claims pending/ rejected for requirement till 30.4.11. Available on site & we’ve written to Mgrs HI. The Branch HI Mentor, BHIM/ Nodal Officer is to follow up with the policyholder for submission of requirements by y 30.6.11.
A lot of companies put a summary of their plans online. But I advice you to read all the rules thoroughly to understand all the rules. Then if you found every thing clear then take the policy .
ReplyDeleteThanks
William Martin
Financial Claims Made Simple
Thanks for sharing this valuble information,it is useful for us and LIC
ReplyDeletecustomers in Hyderabad
Thanks for sharing this valuable information and it is useful for those who need LIC Advicer in Hyderabad
ReplyDelete