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november 2015 year
november 2015 year
exclusively for Capital

Health Insurance: How to Be Indemnified For the Treatment You Paid For Yourself

exclusively for Capital

A lot of voluntary health insurance policies stipulate the possibility for the insured to pay for the treatment with being further indemnified by the insurance company for the same amount.

It is obviously more complicated procedure compared to standard approach implying that insurance company settles accounts with medical institutions and drug stores directly. It usually works in the emergency cases when the person does not have time to notify the insurer since he is taken to the hospital by the ambulance, Or if the insured needs specific treatment provided by the medical institutions that do not co-operate with insurance companies at all.

What should you do once you face one of the abovementioned situations, in order to be indemnified for incurred expenses in full and in a timely manner? The action plan is below. 

  1. Notify your insurer about the details of your case and let the insurance company know that you intend to receive treatment without its assistance.
  2. Make sure to have your call registered. Write down the name of the doctor who received the call along with exact date and time of your conversation. Get oral confirmation from your doctor stating that you can apply for a treatment and ask for the list of the documents required for indemnity.
  3. Make certain that the medical institution of your choice satisfies the requirements of your insurance policy regarding the class of medical institutions.  Find out about the deductible amount to avoid disappointment in future due to insufficient indemnification.
  4. Follow the rule: the more documents and certificates you gather, the better. Do not forget that confirmed expenses with the mark “charity” will not be covered by the insurance company.
  5. Familiarize yourself with the deadlines for documents submission in advance and do your best to meet them. If you miss the deadline due to the valid excuse, notify your insurance company about it.
  6. If you apply for indemnification without broker’s or HR’s assistance, make sure to make copies of all the documents submitted to the insurance company. Register your application and write down the incoming document’s registration number. If you don’t have an opportunity to do so, use other means of confirmation such as email confirmation etc.
  7. Have an insurance company’s employee confirm that the documents you’ve submitted meet their requirements and are sufficient for you to receive indemnification. Otherwise you might face the request to resubmit the application in accordance with new requirements or provide more documents which will definitely lead to the delay or even denial of indemnity.
Having the insurance company settle all the accounts is the most convenient way of getting treatment for the insured
Our experience proves that having the insurance company settle all the accounts is the most convenient way of getting treatment for the insured. Such approach allows you to save time, money and even your nerves. That is why we always recommend that you should make sure to have the longest possible list of medical institutions to choose from before signing the insurance policy. If we are talking about insuring team of employees who prefer certain clinic, it should not be a problem for the insurance company to add it to the list of the medical institutions covered by the policy. The good thing is that the majority of medical services providers already have agreements of co-operation with the lion’s share of the insurers.