Do’s and Don’ts for Filing a Health Insurance Claim
                     Do’s and Don’ts for Filing a Health Insurance 
Claim

An Overview
Health Insurance has become a necessity in uncertain times. Whether it’s a pandemic virus, critical surgeries, or 
underlying chronic diseases, it acts as a saviour and saves you from expensive medical expenses. That’s why we 
prioritise a smooth and hassle-free claim settlement when we encounter any medical emergency. But you should be 
wise enough to understand that your mediclaim policy has strict guidelines and prerequisites for claim settlement. 
Hence, you should be aware of the Dos and Don’ts that you must do while filing your claim.
Filing a health insurance claim can be daunting, especially when you are dealing with staggering medical bills and 
mental trauma. However, with the right approach and guidance, you can streamline the process and ensure that you 
receive the coverage you deserve. In this guide, we will explore the essentials that you must follow for a smoother 
claim settlement. 
The DO’s
1. Understand Your Policy
Before you file the claim, read the policy and understand what it covers and what it doesn’t. Also, ensure that accurate and 
complete information is provided to the insurer. Errors or omissions can lead to unnecessary delays. Therefore, double-
check all the details before submitting your claim.
2. Keep Detailed Records
It’s essential to keep records of medical bills, receipts, and medical reports and share them with the insurer whenever 
required. Recording your medical expenses and furnishing all the necessary hospital bills and receipts while filling out your 
claim is critical. This step will help you avoid last-minute hassles and prevent health insurance claim rejection. 
3. Timely Intimation
Some insurance companies have strict timelines for submitting claims after hospitalisation or treatment. Make sure to 
submit the health insurance claim on time to avoid unnecessary rejections. 
4. Disclosure of Pre-existing Diseases
If you have any pre-medical condition you didn’t disclose when purchasing the insurance, make sure to disclose it while 
applying for a claim. Failure to disclose pre-existing diseases can directly lead to  health insurance claim rejection.
5. Admit to Network Hospital
 Whenever possible, get admitted to a hospital within your insurance network. This ensures smoother health insurance claim 
processing and reduces the likelihood of coverage disputes.
6. Seek Help if Needed
We know the hassle associated with claim processing, but it can be reduced if you feel overwhelmed or unsure at any stage. 
For insurance claim denials and disputes, you can seek guidance from insurance professionals like Insurance Samadhan to 
ensure you receive fair and timely compensation.
The Don’ts
1. Don’t Assume Everything Is Covered: 
 Just because you have health insurance does not mean that every medical expense will be covered. There are various 
limitations, and your policy only offers coverage to an extent. Therefore, familiarise yourself with your policy coverage, limits, 
and pre-authorisation to avoid last-minute inconvenience. 
2. Remember to Pre-Authorize:
 Some health insurance plans require pre-authorised specific treatments or procedures. Please obtain pre-authorization to 
avoid denying your claim, so check with your insurer before undergoing any non-emergency medical services.
3. Don’t Throw Away Documentation: 
Don’t tear your medical bills, as it is essential to show your healthcare expenses during claim settlement.  Keep everything 
organised in a file or folder for easy access. Failure to show any records or medical receipts can lead to a lesser claim. 
4. Don’t Assume a Denial Is Final
Health claims are hard to crack; hence, don’t assume that your insurer’s rejection of your claim is the end of the road. As 
mentioned, many denials are overturned on appeal, so it’s worth pursuing if you believe the denial is unjustified.
Final Words 
Investing in health insurance is always better to protect you and your family from unexpected medical emergencies. By 
following these do’s and don’ts, you can easily avoid last-minute chaos and claim delays. However, for quick claim settlement, 
you can contact Insurance Samadhan for expert resolutions and speedy claim settlements.
Original Source: https://www.insurancesamadhan.com/blog/dos-and-donts-for-filing-a-health-insurance-claim/