How Senior Citizens Can Increase Their Chances of Health Insurance Claim Approval in India

Health insurance can play a crucial role in ensuring the financial well-being of individuals by providing support in medical emergencies. This is all the more prominent for senior citizens. When one is over 60 years of age, medical issues are more common and the need to raise a claim may be more frequent. However, it can be difficult for older individuals to navigate the claim-raising and settlement process. What can help here is a proper understanding of the key factors that affect claim approvals in health insurance. If the senior citizen is aware of those, they can take the right steps to increase their chances of claim approval. With that in mind, we provide actionable tips and strategies for senior citizens to get their claims settled and receive the healthcare coverage they need.

Ways To Increase The Chances Of Health Insurance Claim Approval For Senior Citizens

Here are some ways you can ensure the claims made on senior citizen health insurance plans are approved:

1. Be Honest When Providing Personal Health Information

When you are buying health insurance for senior citizens, it is important that you provide accurate and complete health information. Failing to disclose relevant information or providing misleading facts related to your health can lead to the rejection of your claim in the future. Senior citizens must disclose any pre-existing medical conditions, treatments, medications, and previous hospitalisations to the insurer. This not only helps in reducing claim rejections, but also allows the insurer to provide the right kind of coverage. When the insurer knows what kinds of diseases and medical issues you are vulnerable to, they can help you customise the policy to suit your needs. Thus, be honest and accurate regarding your medical history with your insurer.

2. Read The Policy Terms And Conditions Thoroughly

Before signing the proposal form for a health insurance plan for senior citizens, it is crucial to thoroughly read and comprehend the policy's terms and conditions. Pay attention to aspects such as waiting periods, exclusions, and sub-limits. Some policies have waiting periods for pre-existing conditions or specific treatments, during which claims related to those conditions may not be allowed. By understanding these aspects of the policy, one can plan their healthcare expenses accordingly. More importantly, they would not have to face unexpected claim rejections arising from policy aspects they were previously unaware of. Claims are subject to terms and conditions set forth under health insurance policy.

3. Pay Premiums On Time

To ensure uninterrupted coverage and increase the likelihood of claim approval, the premium of health insurance plans should be paid on time. If one delays the payment of premium, it can result in policy termination, leading to denial of claims. Usually, if a payment is missed, one may be given a grace period of a few days wherein the payment can be made without any consequences. If the premium is not paid even during this period, the plan can lapse. It may go without saying that a claim made on a lapsed health insurance plan would not be valid. Claims are subject to terms and conditions set forth under health insurance policy.

4. Have Proper Documents In Place

Having the right documentation is crucial when filing health insurance claims. One should ensure that copies of all medical records, bills, prescriptions, and diagnostic reports are present in an organised manner before filing a claim. Also, ensure that all needed forms and documents are accurately filled out. Another thing to ensure is that the documents are submitted on time. Insurers may have time limits within which certain documents may need to be submitted. This can help streamline the claim settlement process and reduce the chances of rejection due to incomplete or delayed paperwork. Claims are subject to terms and conditions set forth under health insurance policy.

5. Select The Right Health Insurance Plan

It is vital to select an appropriate health insurance plan tailored to the specific needs of senior citizens. Look for policies that cover a wide range of medical expenses, including annual check-ups, diagnostic tests, doctor’s consultations, teleconsultation coverage, and so on. You may also want to include additional coverage that includes pre-existing conditions, pre- and post-hospitalisation, and other kinds of medical and non-medical expenses.* This ensures that whenever a medical emergency strikes, one can raise a claim and avail compensation for the treatment costs. Claims are subject to terms and conditions set forth under health insurance policy. To get an idea of what the premium of such a plan might be, you can use a health insurance premium calculator. It provides an estimate of the premium so that you can adjust the coverage such that the premium is within your budget. Health insurance, especially for senior citizens, is not a luxury but rather an essential way of investing in one’s health. It can provide financial support as well as peace of mind, which can help one enjoy their golden years even more. Hence, one must use the above tips and strategies to ensure their health insurance claim is approved so that they can age gracefully without worrying about finances.   * Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.