LIST OF DOCUMENTS REQUIRED AT THE TIME OF BUYING HEALTH INSURANCE

“Health care is not a privilege. It’s a right. It’s a right as fundamental as civil rights. It’s a right as fundamental as giving every child a chance to get a public education.”

Buying a health insurance plan

Buying health insurance is indeed a must. Traditionally, the process of purchasing involved submitting a long list of paper documents or hard copies of relevant information to the insurance company office. However, with the decrease in the offline procedure of usage of physical documents and an increase in the online process with electronic documents, the burden of manual paperwork has diminished significantly.

In today’s digital time, while buying a health insurance, you have to submit a soft copy of the documents online. It highly reduces the paper work and quickens the application process with details fed in the database, that can be accessed easily at any time. Also, the availability of abundant health insurance plans makes it essential to know all the requirements, policy basics, documents, and other factors to compare them before purchasing any plan.

Health insurance in India has grown rapidly at a CAGR of 20% since FY16. It is seen the customer satisfaction of buying health insurance and understanding the data shared and accessed about health insurance plans is relatively high. The young and digitally savvy Indians are increasingly prioritising well-being and health’.

Let’s have a detailed look at the documents that you need while buying any health insurance policy. Note that different insurance providers might have slightly different or additional documentation requirements. It cannot be exactly the same for all. This is a comprehensive general list.

 

Important documents required at the time of buying health insurance

Most essential documents relevant at the time of buying any health insurance plan include;

Age proof - Submitting age proof is an important document while buying health insurance as many policies have a fixed entry age. You also need to provide the age proof of all the members to be insured under the health insurance policy that you have chosen. For applicant age proof you can submit a copy of any of the following documents;

• Voter ID Card
• Pan Card
• Aadhaar Card
• Driving License
• Passport
• Birth certificate
• 10th or 12th mark sheet

 

 

Address Proof – Permanent address proof also needs to be submitted while buying a health insurance plan. Your health insurance company will need to send various communications to your postal address and they also need it for their records. You can submit any of the following documents for address proof;

• Ration card
• Driving license
• Passport
• Rent agreement if applicable
• PAN Card
• Aadhaar Card
• Utility bills like electricity bill or telephone bill
• Voter’s ID

 

Passport-size photographs – You will also need Passport-size photographs of applicants and members of the insurance plan for insurer records.

Medical reports – Some insurers demand a medical report of the applicant and members as well depending upon the plan chosen along with the coverage.

Proposal form – To buy a health insurance plan every insurer will get a proposal form duly filled in and signed by the applicant. It is used for purpose of their future records.

 

Having looked at the relevant documents needed at the time of buying insurance let’s now see what documents are a must as you file a claim for insurance.

 

List of documents required at the time of claiming health insurance

Most essential documents relevant at the time of claims for any health insurance plan include;

 

• Original claim form duly filed and completed along with your signature
• Valid identity proof of applicant or members
• Medical certificate of the affected
• Doctor’s prescription signifying treatment in hospital
• Doctor’s prescription counselling diagnostic tests, medicines, and consultation
• Indoor case papers
• Investigation report
• Ambulance receipt
• Original pharmacy bills
• First Information Report (FIR) or Medico Legal Certificate (MLC) as required, in case of an accident
• Other policy details that include the policy number, name of the insured, address, the coverage and disease for which treatment is on
• Additional documents that may be required by the insurance company to assess the claim, in case there is a hint of fraud

For the claim process to complete, the insurance company will verify all the documents submitted and evaluate the claim amount to be transferred to you. The claim amount will then be credited to your bank account.

 

Documents required for the option of cashless medical insurance claim

There is also an option of a cashless medical insurance claim in which case you need not worry about submitting any medical documents or bills to the health insurance company. The hospital where you are undergoing treatment sends all the required documents and treatment details to the health insurance provider in case of any claim filing.

The documents required for cashless treatments are;

• Claim pre-authorization form
• Valid ID proof
• Passport sized photographs
• Identity proof documents such as PAN Card, Voter ID, Driving License, and Aadhar card

 

The claim form and the documents should be sent to the Insurer or the Third-party Administrator. Keep in mind, the documents required for cashless claims in a network hospital are slightly different from the ones required for registering a reimbursement claim. Have a clear check on the list of documents required before filing the claim to avoid any issues.

Health insurance is not a product or service that you browse and buy erratically. You need to carefully understand your health insurance need, know all the documentation requirements and the basics of health insurance to get the best out of your health insurance policy you plan to purchase.

 

“Health insurance should be a given for every citizen.”

 

FAQs – Frequently asked questions

 

Let’s look at some frequent queries on Documents required at the time of buying health insurance;

 

Q1. Are there any exclusions while buying health insurance?

Yes, there are exclusions while buying health insurance, hence it is highly essential to go through every detail carefully while buying a health insurance policy along with its list of exclusions. These are situations in which you cannot raise a claim. Usually, an insurer has a fixed set of exclusions, but it is important to know which exclusions are in force on your particular health insurance policy.

 

Q2. Are there any other parameters to be checked essentially apart from documentation while buying a policy?

Yes, one needs to check the sum insured and the waiting period. The main feature while buying your policy is the amount of sum insured. This will decide the extent of coverage while you face an unfortunate event. Remember that higher the sum insured, higher will be the cost of your health insurance policy. Now, many policies have a waiting period before it can provide financial aid for a specific medical condition. For example, the maternity benefit in a women’s health insurance plan can have a waiting period of two years. Keep a lookout for these factors as well before buying a health insurance plan.

Q3. Are there claim options with different documentation?

Yes, when you file a claim, you can do it in two ways, either cashless or reimbursement. For reimbursement you submit the relevant list of documents, pay the bills and then ask for your insurer to compensate you for the financial loss. To be able to raise a cashless claim, you need to avail treatment only in a network hospital. This is because your insurer will have a network of hospitals where they will directly settle the bill with the authorities. You do not have to pay much, just the deductibles. While buying a health insurance plan look for an insurer with a large network of hospitals for your convenience.