It is important for you as a policyholder to know how to make a medical insurance claim or health insurance claim procedure, especially if you need immediate treatment due to being involved in a road accident or falling ill suddenly. This article will explain how to claim medical insurance to make your business easier.
How to Claim Medical Insurance?
As mentioned above, each insurance company has a different insurance claim procedure. Therefore, you can consult with your insurance company to be sure. Here are the medical insurance claim methods that are usually used by insurance companies in Malaysia:
1. Notify Your Insurance Company.
The first thing you are advised to do is to inform your agent or insurance company immediately when you need to seek treatment in hospital. You can also consult with your insurance provider to be sure whether your treatment is covered by your insurance policy or not.
In addition, this will avoid delays or confusion and at the same time ensure that your treatment goes smoothly.
Know Your Policy.
The medical insurance claim process may vary depending on the insurance company and the type of policy you choose. Because of this, there may be many out there who face difficulties when it comes to making a medical insurance claim. First of all, it depends on the type of insurance policy you have. Generally, there are two ways to claim your health insurance depending on your policy either cashless policy and reimbursement policy. Here are the differences you need to know:
Cashless Policy.
With a cashless policy, you don't need to pay an advance or deposit to cover medical bills. For example, you only need to use a medical card at a panel hospital and the insurance will cover your health expenses. If you do not have a medical card, you can contact your insurance company and ask for a Letter of Guarantee to be given to the panel hospital.
Refund Policy.
To claim medical insurance through this policy, you need to make a payment using money from your own pocket first. After that, you need to make a claim from your insurance company to get back the money you have spent on treatment. In addition, the following are situations that may cause you to have to pay the treatment bill first before the insurance claim:
Get treatment at a non-panel hospital. In this situation, you need to settle your hospital bill first and make a medical claim after you are discharged from the hospital or after treatment is completed.
Getting treatment while abroad as you may not be able to use your medical card. However, you may be able to claim a refund depending on the terms and conditions of your insurance policy.
Your insurance company does not issue a Letter of Guarantee. This means that you have to pay your hospital bill first and make a medical claim after you are done with treatment.
Also find out if the hospital where you get treatment is part of your insurance panel. Such things your insurance company has all the answers. Because of that, it is important that you consult with them first to review how to claim your medical insurance.
2. Prepare the Documents Required by the Insurance Company
After getting all the information and certainty from the insurance company, you now need to prepare the documents required by them to start your health insurance claim. Here are the documents you usually need to provide:
Photocopy of identity card
Original hospital receipt and invoice
Hospital bill
Diagnostic report
Passport, boarding pass, flight ticket information, and hospital bill if you seek treatment abroad
3. Complete your Medical Insurance Claim Form
This one you need to get from your insurance company. Usually, you can get a claim form through your insurance company's website. However, if your insurance company does not provide a form on the website, you need to contact them to get a claim form for you to fill out.
4. Making Document Checks and Copies
Before you submit your claim, do one last check to make sure all the information you provide to the insurance company is complete and most importantly accurate. In addition, you are advised to make copies of your forms and documents either physical or digital copies. These copies may help you if there are any problems with your claim later. It is important that you are always prepared to face any unexpected things.
5. Submit Your Claim to the Insurance Company
After everything is complete, you can submit your claim to your insurance company either directly or through your insurance agent. Some insurance companies provide facilities for you to make online on their website. Check with the insurance company to be sure.
Don't Delay, Get Your Insurance Cover Now!
You may feel that there are many things that need to be done, many documents that need to be prepared and forms that need to be filled. But did you know, there is a time limit to be followed to make a medical insurance claim? Usually, you will be given 30 days of treatment for your health insurance claim. You need to consult your insurance company to get certainty about the period limit that has been set.
If you miss the period or claim after the given time limit, your claim application will most likely be rejected. Therefore, you need to act quickly in such situations to avoid losses. Make a medical insurance claim application immediately as this is your right as a policy holder. Lose if you defer because the cost of your treatment can be covered by the insurance company instead of your own money.