Health Insurance Claim Settlement

The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.

Claiming your health insurance plan is the ultimate step of buying one, more like the whole reason for any of us to buy them. However, health insurance claims are not easy to submit and settle at all times. Claiming is a multi-step process and several factors can make the claim settlement application go waste. But even then, in the end, we all need and want speedy settlements for our health insurance claims, or any other kind of claims for that matter. This piece will focus on providing a few easy tips and tricks to get your health insurance claims settled faster and more efficiently.

Get Familiar with the Process Beforehand

You will face a great deal of additional busywork if you are not already familiar with the claim process of your provider. While most claim procedures are the same for both the best health insurance in the UAE and the basic ones, some key steps may differ for each provider. It is best to talk to one of the customer service executives about the claim process for your health insurance plan when you buy it. Know the exact steps you need to follow and in what order. Also, remember that health insurance plans can be settled as both direct claims and reimbursement claims. This means you will have to understand both these processes separately. Pay extra attention to the reimbursement claim process since it includes more steps and may require you to work a bit harder.

Hide Nothing About Your Medical History

Disclosing your correct medical history is one of the most important aspects of having your health insurance claims approved swiftly. If you hide any pre-existing conditions that you have, your claim will not only get longer to process but will also get denied. If the insurance company has to take additional time in order to investigate your medical history, the claim process is stretched. Letting the provider know all about your medical history will help in evaluating the coverage you have with them and then settling the claim accordingly. The more transparent you are with your health conditions, the easier your claim settlement will be.

Be Ready with All the Documents

Whether it is direct cashless claims or reimbursement claims, always be ready with the required documents. Missing out documents from the recommended list is the biggest reason for claim settlement delays as well as rejections. There aren’t many documents you will require for direct claim settlement. But the scenario is different with reimbursement claims. From the claim form to every single receipt and invoice of the services and treatments you are claiming, there is a lot to gather. Make sure you have all these documents with you in both physical and scanned form.

Opt for Online Claim Submissions

Health insurance claims can be submitted via both online and offline channels. However, it is best if you opt to submit your health insurance claims online. Most health insurance providers have gone digital now. The online claim submission platforms are full-fledged with an automated initial scanning process. This means that your claim will not only get submitted instantly, it will also take less time to get processed. Not to mention it is incredibly convenient to file your claims online.

Never Throw Away Your Receipts

While you won’t need any when making a cashless direct claim against your health insurance plan, every single receipt is important when it comes to your reimbursement claims. Not only the receipts of the treatments, services, medicines and tests you want to claim but also credit and debit card slips and cash payment memos. Needless to say, you must not throw away any of your receipts if you want your claim process to go smoothly. Save them and make a copy for your benefit. Your provider may ask you to submit the originals. Once submitted, original receipts are not returned if the claim is approved.

Avoid Errors to Avoid Claim Rejection and Resubmissions

To err is human. But this habit may land you in trouble when it comes to your health insurance claim settlement process. If your claim form has any administrative errors, if the document set is missing a receipt/bill, the claim gets rejected. Of course, you can submit your rejected claims again after correcting the said mistakes. But the whole rejection and resubmission process delays claim settlement process. Hence, proofread and double-check for everything before submitting.

Understand the Process of Family/Friends Filing Claims on Your Behalf

If you are hospitalized or still recovering after your treatment, you may not be able to submit your claims for your insurance plan. A family member or close friend may be required to do in your place if an instance like this takes place. Hence, pick out a few people who would most probably submit the claim on your behalf and let them know about everything important related to your health insurance claim settlement process. Spread the awareness to make sure that the claim is settled speedily, irrespective of who files it.

Be Aware of the Deadlines

Most blunders happen when you do things in a rush. And blunders will result in claim rejections and resubmissions. To avoid that, make sure you begin the claim submission process when in advance before the deadline. Manage the submission work accordingly so you have enough time to not only collect everything you need but also to recheck everything multiple times.

A Few Things to Remember About Health Insurance Claims in the UAE

All the claim forms, for direct or reimbursement claims, are supposed to be filled either in Arabic or English.
The documents to be submitted are also supposed to be either in English or Arabic.
Most insurance providers set a deadline of 30-180 days for reimbursement claims. Talk to your provider about the exact length of the submission period for your claims.
The settlement is generally done in 15-20 days. Yet again, talk to the provider to know the exact timeline.
Make copies of all the original documents you submit. This includes invoices, cash memos and card receipts.
A doctor’s record may be required. Find out in advance if your provider needs to bring in a personally written account of your treatment from your treating doctor. Try to obtain it in time.
Always be one step ahead by proofing your claim form and rechecking the documents. Try and make submissions online to reduce hassle.

In a Nutshell

The steps of filing a health insurance claim always stay more or less the same across all platforms. The things that can be done to speed up the settlement process mainly depend on your efficiency and the information you possess about the process. If you are already an expert and well-learned in the ways of submitting a claim properly, chances are it will be settled swiftly. Just make sure that you apply all the aforementioned tips when you are out to submit a health insurance claim and complete the process properly.