Five conditions of health insurance claim

Health insurance claims do not necessarily require five conditions, depending on the product terms. If you want to make a claim, you first need to meet the claim conditions, such as critical illness insurance. It is generally necessary to diagnose a disease/reach a certain state/perform an operation. Secondly, apply for claims within a certain period of time after the insurance accident, and the claims data should be prepared and submitted. After passing the audit, you can generally get the claim smoothly.

Health insurance mainly includes sickness insurance, medical insurance, disability income loss insurance and nursing insurance. Different types of insurance require different claim information. When applying for claims, you need other information besides the applicant's ID card and insurance contract. If you are insured with critical illness insurance, you need to provide the diagnosis certificate and inspection report of related diseases; If you have medical insurance, you need to collect the diagnosis certificate, the detailed list of cases and expenses. If you want to know the claim data of other insurance types, you can read this article: What are the claim data? Details determine the success or failure of claims!

After the claim materials are fully prepared, apply to the insurance company for insurance payment and hand in these materials at the same time. After receiving it, the insurance company will verify it within 5 days; If the situation is complicated, it shall be approved within 30 days. Generally speaking, as long as the claim conditions are met, the insurance company will make a claim. If the insurance company refuses to pay compensation, it may be because it is in danger during the waiting period, involving exemption clauses and not telling the health status truthfully. What if these problems are involved? You can read this article to understand the correct operation process of settling disputes.

In addition to the waiting period, exemption clause and health notice, it may also be because the claim conditions have not been met. For example, incomplete protection. If you are equipped with critical illness insurance and lack the protection of Chinese medicine, you may not be able to get claims or only get a small amount of claims when you are unfortunately suffering from Chinese medicine diseases. Another example is the grouping of serious diseases. If the grouping is unreasonable, a second claim may not be obtained. Buying insurance should not only pay attention to claims, but also pay attention to its protection content and some insurance details. Senior sister suggested that you read this article before buying insurance: before buying insurance, you must first understand these key knowledge points!

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