Critical illness insurance provides an extra layer of financial security in the event of complex medical emergencies. If you are diagnosed with an insured event of your policy, you can file a critical illness insurance claim to receive a lump sum benefit to pay for your expensive treatment.
If you are planning to initiate a claim on your critical illness insurance policy but don't know how to go about it, this blog is for you.
We will discuss the critical illness claim process in detail, along with a few additional tips for a hassle-free settlement of your claims.
When Should You File a Critical Illness Insurance Claim?
Understanding the
importance of critical illness insurance is not enough to buy the right plan. You must also be aware of its claims settlement procedures.
The process for critical illness insurance claims is slightly different from regular health insurance claims. Hence, it becomes important to understand the right time to file a critical illness claim.
When you purchase a critical illness insurance plan, it comes with a waiting period. You need to complete this waiting period before claiming with your policy.
Our Critical Illness Insurance has a waiting period of 3 months. This means you are eligible to file a claim three months after your policy's inception.
In the event of a claim for insured illness, you must intimate your claim within 7 days of getting your first diagnosis. You are required to provide all the details of your illness along with the prescribed surgical procedures.
Here are the details you need to provide at the of critical illness claim intimation:
- Policy number
- Name of the policyholder or the insured for whom the claim is being filed.
- Type of disease.
- Name and address of attending physician and hospital.
- Date of medical procedures.
- Any other information requested by our claims settlement team.
Please note that the process and critical illness claim time limit can be more or less depending on your insurance provider. Hence, confirm the specific details for your critical illness insurance plan before proceeding further.
How to File a Critical Illness Insurance Claim?
The critical illness insurance process is simple. Following are the main steps you need to follow to lodge a claim:
Step 1: Claim Intimation
It is the first step for making a successful critical illness insurance claim. As mentioned above, you must inform our claims team (RCARE) soon after your first diagnosis for an insured disease.
Note that it is important to intimate your critical illness claim within 7 days of receiving your initial diagnosis results. Any type of delay in claim intimation can lead to denial.
To begin your claim process, contact RCARE at 022-4890-3009 (a paid number) or email rgid.rcarehealth@relianceada.com.
Step 2: Get Your Treatment Done
Once your claim request is recorded, you can get your critical illness treatment done on the desired dates. Make sure to save all the medical invoices, receipts and bills, as they will be used for the claim process.
Step 3: Claim Procedure
Fill out the critical illness insurance claim form and submit it along with the original documents relating to your hospitalisation or treatment to RCARE Health.
Make sure to submit these documents immediately but not more than 15 days after your discharge.
While you can send the scanned copy of documents for faster processing, you can do so online if needed. Here is the address of our claims team:
Rcare Health: Reliance General Insurance, No. 1-89/3/B/40 to 42/ks/301, third floor, Krishe Block, Krishe Sapphire, Madhapur, Hyderabad (500081) |
Step 4: Final Decision
Once your claim is lodged, RCARE will adjudicate it as approved/repudiated/seeks additional details, if needed.
Documents Required for Critical Illness Insurance Claim?
- Duly completed and signed
Critical Illness Claim Form. (Original)
- Signed referral letter from the medical practitioner and hospital advising hospitalisation.
- The original prescription letter mentioning prescribed drugs, treatment and diagnostic tests.
- Discharge letter from the hospital or medical practitioner.
- Original diagnostic test reports and payment receipts for incurred medical expenses.
- Indoor case papers.
- FIR (if applicable)
- Post-mortem report (if applicable)
- Any additional documents requested by the claims team.
The approval of critical illness insurance claims entirely depends on the accuracy and sufficiency of the supporting documents. Hence, it is crucial to submit all the necessary documents promptly and accurately.
Tips for Smooth Critical Illness Insurance Claim Settlement
Understand Your Policy Terms
The benefits and coverage offered by critical illness insurance can be different for different providers. Hence, the first thing to do before raising your claim is to understand the policy wordings and critical illness diseases covered under your policy.
It is a crucial step because your claim will be denied if it is not for the insured event of your policy. You can read policy wordings and brochures for your insurance plan.
Avoid Delaying Claim Intimation
It is critical to keep up with the given critical illness claim time limit. Simply put, you must inform your insurer right after you are diagnosed with an illness covered in the policy.
As we have discussed, different insurance providers have different timelines. At Reliance General Insurance, you are required to intimate your critical illness claim within 7 days of your initial diagnosis.
Learn About Requirements
The requirements for critical illness insurance claims may differ from those of a regular health insurance plan. Hence, it is strongly advised to learn about the requirements in advance to avoid any delays or rejection.
Gather Supporting Documents
From your prescription letters to medical bills and discharge papers, arrange every supporting document to strengthen your claim.
A good idea is to create a medical folder with all the original documents to avoid losing or misplacing any important paper.
Stay Informed
Once your claim is lodged, don't just sit back and relax. Instead, take regular follow-ups from the claims settlement team and stay informed about their processing. This simple step will ensure a timely resolution of your claim.
Conclusion
Understanding the critical illness insurance claim process is important for a prompt settlement.
At Reliance General Insurance, we understand the need for financial assistance in coping with chronic health conditions. Hence, we offer smooth and obstacle-free claim processing for our
Critical Illness Insurance.
Our comprehensive health insurance plans and dedicated claims settlement team ensure all-around financial protection.
Get our
health insurance plans today and access quality healthcare without worrying about your bank balance.
Contact us today!
Frequently Asked Questions
Can I cover my spouse under my critical illness insurance?
No. Reliance Critical Illness Insurance is an individual policy. It can be purchased for only one person.
Do I need to take a medical test before purchasing Reliance Critical Illness Insurance?
If you are over 45, you must undergo medical screening. For those under 45, no pre-medical screening is required to buy the plan.
What is the minimum age for buying critical illness insurance?
The minimum age for purchasing critical illnesses insurance from Reliance General Insurance is 18 years.
Is cancer covered under critical illness insurance?
Yes. Cancer is covered under the Reliance Critical Illness Insurance policy.
My critical illness claim is denied. What to do?
In case your critical illness insurance claim is rejected, you can raise an appeal through the
Grievance Redressal system. Keep in mind that appealing a critical illness claim is only recommended after understanding the actual reason behind the rejection.