Disputing Health Insurance Claim

You never realize how good or bad your healththe right to dispute it. Insurance companies have to
insurance is, till you come across the time when yougive the reasons for which the claim was rejected, in
have to file the claim. There are some companieswriting. You may also take legal help if it is a big
that impose numerous protocols on you, making youamount and you badly want the insurance money.
sick of running around for the claims. So, it is betterBefore that, you have to speak to the customer
to invest in a health insurance company that isservice of the department and see if the matter can
known to be good and easy when it comes tobe sorted out. Talk to someone high in authority and
processing claims.see if he can solve your case or give you a
How do you file a health insurance claim? You maysatisfying answer.
have to call up the toll free number listed on theWrite an email to the claims manager, the vice
website and they will ask you to fill a form withpresident of the company or someone who is charge
relevant details about the illness. You can alsoof handling grievances and see if you get a good
download the claims submission form from thereply. Make sure that you write everything in the
website and fax or email to them. Most healthletter, your insurance claim details, the case numbers
insurance companies accept the doctor's letter aswhich were given by the customer service
vital proof with a mandatory provision that a personexecutives when you spoke to them on phone, the
should be hospitalized for 24 hours. There are somereplies you have got and all other supporting
health insurance companies who tie up with thirddocuments or materials that you could possibly
party providers who handle the claims part.provide to support your case. You may even ask
There are some health insurance policies who will giveyour doctor if you are in his good books to help you
you limited coverage for certain diseases andout with the matter. He will also be in a position to
procedures and expect you fund the remainingescalate the matter.
amount. There are some cases where you are givenWhen everything fails, you can write to the
full refund and there are also cases in which you areregulatory body of the health insurance company or
given cashless benefit. For that you may have tothe headquarters of the insurance company. You can
look up at hospitals that are tied up with youralso send a mail to the regional health officer citing
insurance company.your problem. If you feel that your claim should be
Insurance companies do pay for the claims if thehonored, you can go higher up through proper
paper is in order and nothing can be argued with.channels, apply pressure and see it to that they give
However in case, the insurance is rejected, you haveyou a patient hearing and give a satisfactory reply.