Claim process of Group Health Insurance – Infographic

To file a claim under a group medical insurance policy, you will need to follow the steps outlined by your insurance company. Below is a general outline of the process you can expect:

1. Consult your policy documents: If employed, your corporate health insurance policy documents should include coverage information and the claim filing process. Before starting the claims process, ensure that you have a clear understanding of what is covered and what is not.
2. Seek medical treatment: In case of injury or illness, it is crucial to seek immediate medical treatment. Keep and submit all treatment-related receipts and documentation to your insurer for claim purposes.
3. Contact your insurance provider: Contact your insurance provider to inform them that you need to make a claim. You will be provide a claims form, that you can complete and return with any supporting documents.
4. Submit your claim: Once you have filled the claims form and gathered all of the necessary supporting documents, submit your claim to your insurance company. Ensure that you to keep copies of everything you submit for your own records.
5. Wait for a decision: Your insurance provider will review your claim based on submitted documents and make a decision about whether or not to approved. This process is sometimes time-taking, so be patient.
6. Appeal a denied claim: In case your claim is denied, you have the right to appeal against the decision. Your insurer will provide information about how to pursue this further in their decision letter.

Note that the claim process for group health insurance may vary among insurers. Ensure that you follow their specific instructions to ensure seamless processing of your claim.