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With the rising case of Covid-19, there have been reports of hospitals denying or delaying cashless treatment forcing families and caregivers to pay hospitals bills upfront. If you have had gone through the situation don’t be disheartened as there is a way to claim this amount online from your insurer through the reimbursement process. Last year due to the social distancing requirements in the case of Covid-19, IRDAI directed all insurance companies to settle reimbursement cases online which require soft copies to be scanned and emailed by electronic means for the claim processing.

With digital integration, many insurance companies have introduced a digital claim process so as to enable customers to file a health claim in a seamless and faster manner.

Online claims

Bhaskar Nerurkar, Head – Health Claims, Bajaj Allianz General Insurance, said “Firstly, there is an online registration process for which the customer needs to set up their account with the insured. Post that, the customer needs to fill up the claim form and submit all the requisite documents as needed by the insurer. The online process also helps the customer understand information such as SI, deductibles, how much claim is covered, benefits that the customer gets, exclusions etc. In case some documents cannot be uploaded by the insured, the same can be submitted to the local branch office or can be couriered to the company’s head office or can also be scanned and emailed to the designated email IDs mentioned in the policy document. ”

The insured can also reach out to the agents for the online submission of documents. Additionally, insured can upload their documents on the insurance company’s app and can subsequently track the entire claim journey. Once the customer completes the claim process, it then goes into the system for claim settlement by the insured. Once uploaded these documents are scrutinized by the authorities before processing the amount.

Upload bills

“Most insurers moved to digital process last year for reimbursement of hospital bills. There is no need to submit the bill physically as one just needs to upload it on the app or the website of the company. The documents can also be emailed to the insurance company. The earlier one starts the process the better it is for customers,” said Amit Chhabria, business head at PolicyBazaar.com.

The first preference for everyone should be to pursue a cashless transaction. If the cashless claim gets rejected or the patient has chosen to go outside the network of hospitals, then he should opt for the reimbursement process and submit the claims as soon as he’s discharged from the hospital. “Now, the regulator has approved and instructed all the insurance companies and TPAs to accept claims through electronic medium. So you can attach your photographs and scanned copies to the app and then send it to the administrator who will process the claims. Typically, these claims are processed within five to seven days,” said Girish Rao, chairman and MD of Vidal Health.