Here's a quick check-list on the "dos" and "don'ts" which will make your health insurance claim settlement process simpler. 

The Do's... 

1. If you are taking the cashless route, in case of planned hospitalization, intimate the insurer before getting admitted. If it is an emergency, try to bring it to the notice within 24 hours of the hospitalization. 

2. If you are not at a network hospital and want a reimbursement, collect all the relevant documents and ascertain where to send across for getting the claim. 

3. You should always provide full and correct information in the settlement form. One must also share all information pertinent to the subject matter of the insurance to the company - in case of health insurance, existing insurance policies and pre-existing health conditions/diseases are to be disclosed at the time of proposal. At the time of purchase an honest declaration might shoot up the premium slightly but will ensure that your case is not repudiated when you need to make a claim. 

4. You'll have to provide adequate evidence to support the authenticity of the claim and get the maximum permissible amount under the policy. Thus, it is prudent to preserve all the important supporting documents such as receipts of the purchase, bills, prescription etc. until the matter is fully concluded. For example, to make a claim for hospitalization on one's health insurance policy, the following documents will come handy.

First letter of consultation and advice for hospitalization 

* Consultation Receipts 

* Medical reports, bill receipts and doctor's letter for all tests performed 

* Discharge certificate 

* Duly stamped and signed hospital bills with receipts 

* Medicine bills along with doctor's prescriptions for the same 

5. One must ensure policies are renewed on expiry and all the premiums are paid on time with their due amounts. 

6. If there is an alteration or development in the subject matter of the insurance, then the insurer should be kept updated to avail continued coverage under the policy. 

...And the Don'ts 

1. Falsification of claim may not only lead to benefits being forfeited, but also cancellation of the policy and a potential refusal of all future insurance cover as no insurer would like to do business with someone perceived as dishonest. 

2. Making small, repeated, questionable claims will either shoot up your premiums or eventually your claims will start to get dismissed. 

3. Delay in reporting the loss to the agent or the insurance company may go against you. Similarly, there is always a stipulated timeline to furnish the required documents to make a claim, which should be honoured. 

4. In case all details pertinent to the loss are not available, the insurer should be notified to this effect and their permission sought for extension of time to submit documents. 

Adhering to the above measures can ensure that the insurer can process the claim efficiently, which in turn translates into quicker payment for the claimant  

Source :      economictimes.indiatimes.com