Steps to Filing a Claim for COVID Insurance | Vital

Filing a Claim for COVID Insurance? Having the Right Health Cover Can Make All The Difference

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The pandemic has prompted a quick recognition of the importance of protective investments, particularly in the areas of health and life safety. When it refers to return-based devices, health insurance has grabbed the lead, both in terms of ensuring access to great treatment and in terms of investing in healthcare expenditures. There has been a promising 30-40% increase in health insurance usage among sector players, with some witnessing a larger increase than others. It goes without saying that suppliers with a strong digital distribution mechanism and easy access will benefit greatly from this increase. 

However, the picture is not entirely rosy. The health insurance sector is dealing with a number of issues and uncertainties as a result of the pandemic. Let us see how to obtain a seamless COVID insurance claim settlement process with the right health insurance policy

Will Your Health Insurance Cover COVID-19 Hospitalisations?

Insurance claims are rising in tandem with the number of COVID-19 cases. Although insurers have been quick to settle claims on COVID-19, some cases have been turned down. In terms of coverage, every health insurance policy today, by default, covers COVID-19 treatments.

When you are admitted to the hospital, your insurance has the option of rejecting your claim or not settling it at all. A hospitalization must technically check four boxes to be covered by health insurance. Firstly, the hospitalization must first be approved by a medical professional. Secondly, you need to be hospitalized for at least 24 hours to be able to file a claim. Thirdly, it should adhere to accepted treatment recommendations, and, most critically, it should include an active treatment line that can only be performed in a hospital. For example, if you have moderate COVID-19 symptoms and are simply taking oral tablets with no extra treatment, and you can also be treated at home, this hospital treatment will not be covered by your health insurance. In that case, you will need to check whether your insurance covers home treatments or not.

Things To Be Wary Of

However, it is critical to understand what is and is not covered under your health insurance plan before filing a claim for COVID insurance. Several insurers have released a list of COVID-19 treatment includes and limitations. This is especially applicable to people with pre-existing diseases that can cause complications amidst the Coronavirus infection, especially lung problems and diabetes. Make sure that your health insurance is up-to-date with your current health status, including any minor disease that you might have been affected with recently.

If you have recently purchased a policy, please also be sure that you have completed the required waiting period so that your claim is applicable. Claims filed during an ongoing waiting period will be rejected.

Filing a Claim for COVID Insurance

You must follow the correct claim process to have a smooth claim experience. Even though the method for filing a COVID insurance claim is the same as for any other claim, you should proceed with caution.

How To File A Health Insurance Claim?

You must first select whether you want to file a cashless claim by seeking treatment at one of your insurer’s network hospitals or seek hospital treatment of your choosing and then file a claim for repayment of the costs incurred. You must notify the insurer about your hospitalization and make a claim request as either cashless or reimbursement.

You will not be responsible for paying the hospital cost if you receive cashless treatment; instead, the insurer will settle the account directly with the hospital. During the reimbursement procedure, you must pay the full hospital bill on your own while receiving treatment of your choice. The insurance will refund you for the expenses you have incurred, subject to approval.

Steps Taken For Seamless COVID Insurance Related Claims Settlements

All insurers have been required by the regulating body to handle any claim linked to COVID-19 within 2 hours of submitting a request, for the benefit of the clients. Following the IRDAI’s suggestion, many insurers have established a specialized claims team that will exclusively handle coronavirus claims to process them as quickly as possible. This staff maintains direct contact with the consumer and responds to their claim request as quickly as feasible.

The hospital will do an RT-PCR test to check for coronavirus infection before providing COVID-19 medication. Private laboratories across the country have been instructed to cap test prices by state government rules, and a test can only be performed at a NABL-accredited lab.

If you are admitted to the hospital for infection treatment, your insurance will cover the costs of the COVID-19 test. Charges earned 30 days before and after a hospitalization come under the category of pre and post-hospitalization expenses and are covered by the health insurance plan in all situations.

The Final Word

The pandemic had led to a meltdown of the healthcare system in the country, especially during the second COVID-19 wave.


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