It is difficult to imagine the present-day world without insurance. People issue agreements with insurance policy providers to protect their health, property, business, and so on. Some emergency cases can be covered by the insurance company in full volume. This is the best way to keep your life and activities safe. One of the essential documentation in the relationships between insurer and customers is the insurance claim.
This claim is the document in the form of the official request that is issued by the insurance policyholder. The customer asks the insurer about financial compensation or fractional coverage of the case with the help of the claim. The insurance company processes the request and decides on its validation or denying.
If you are the insured individual and you need to submit an insurance claim, there are five common steps to undertake. Take a closer look at the algorithm that can make the procedure easier. Submission of the insurance request is not complicated if you have an idea on how to act.
Step 1: Collect Receipts and Bills
You need to prepare all the official documentation that proves the fact of your compensation request. Collect your medical receipts or bills that should be covered by your insurer according to the claim. It is useless to request insurance payments if you cannot provide documentation on your case. That is why ask your healthcare specialist or another company about the receipt or a bill to itemize and add to your insurance claim.
Do not forget about detailed information on the healthcare establishments and organizations that have provided you these documents. It is better to specify their address, license type, and other data in your request.
Step 2: Complete Your Claim Form
If you are interested in insurance claim payments, you need to fill in the special-purpose form. Complete it and do not forget to attach all the files with bills and receipts that we have mentioned before. Today it is possible to fill in the claim form online or print it and complete the document manually.
Each insurer can offer different claim forms to fill in. But most of these documents ask for the personal information of the insured person, insurance information, claim reasons, additional information on the healthcare service providers and other organizations. The claim form can also contain the following details to specify:
- Insurance type (individual police or group police);
- Background information about your case and conditions;
- Doctors’ names, addresses, contact telephones, the address of your medical center;
- Out-of-pocket expenses that the claimer has already paid.
Speaking about the last point, out-of-pocket expenses can be various. They depend on the insurance conditions and situations. If we speak about healthcare emergency cases, these expenses can be related to the purchase of pills, injection liquid, and other medical services. Do not hide any information that can come in handy for the claim approval.
Step 3: Review, Copy and Send Your Claim
Having made a copy of the insurance claim, it is high time to review the document. The human factor can take place. So check all the information specified in the form and files attached to the request. Now, you have no need to make a printable copy – just send the claim via email or fax. This way you will make the procedure faster and exclude the risk of paper documentation loss.
If you have decided to send the claim via mail, select the service provider with good tracking and confirmation optionality. Additionally, contact your insurance company by phone. Call your insurer to inform it about your written claim. You can specify the time when you sent a letter with a request. Optionally, you can call your insurance company beforehand. Maybe your insurer is waiting for a fax or an email, not a mailing printable filled-in form.
Step 4: Wait for Reply
This is the most annoying time. But try not to contact your insurance company every day asking about your request status. The insurance claim will be processed as soon as possible. Moreover, if you got confirmation that the letter with your form is received by the insurer. But if you have already decided to contact the insurance company, try to record the date of your call and time.
Note that the insurer can ask you to correct some information. Do not react very aggressively if the company sends your letter back. It is better to do corrections and forward the claim that is filled out correctly. This way your chances to get financial compensation from the insurer are increased.
To sum up, the procedure of the insurance claim submission is not very complicated. At the same time, some insurance companies request a big scope of attached files and other useful information. If you are puzzled by the procedure and have some doubts related to the insurance claim form filling-out process, it is better to ask a competent attorney for legal assistance. An experienced lawyer will help with all the formal approaches. Read more helpful articles in our blog!