Health Insurance 444 views August 2, 2021

Considering the rising health risks, more employers have started offering group health insurance policies to their employees. Under a group health insurance plan, employees don’t need to pay the premium towards the plan. Employees often ask about the process to claim health insurance from their employers when starting a new job.

Well, for a successful claim on your group health insurance, you need to complete a few formalities to make sure your plan starts covering yourself and your family.

On this page, we will be talking about the formalities you need to make to enjoy the benefits under a group health insurance plan. Let’s start!

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Things To Ensure Before Filing a Group Health Insurance Claim

We have talked about the steps below that you need to ensure before filing a health insurance claim from your employer. Do check.

Updation of Your Family’s Profile

When you start a new job, the employer will provide you with an employee ID. Once you get the ID, you will need to update the details of your family (Name, Age, Occupation, Medical History, etc.) on the insurance portal of the company. It is one of the crucial steps to claim health insurance from your employer. The reason being the insurer will not approve your claims if you have not updated the correct details about your family.

Obtain the Health Insurance E-card

Once you have updated your family’s details, the employer will issue your health insurance policy. After which, the employer will give you a Third-party Administrator (TPA) Card. This card will be crucial when going for cashless treatment in a network hospital as it will help the hospital verify your details/

Remember to Bring Your Employer’s E-card

When going for cashless treatment, do bring the identity card (E-card) provided by your employer. This card will help you in case you misplace or forget to bring your health insurance e-card. You can always submit your company’s E-card. In such a case, you will also need to submit one of your photo IDs (Aadhar Card, PAN Card, Passport, Driving Licence, etc.)

Get Information About the Policy’s Features and Benefits

You should always read the policy documents thoroughly to understand its features and benefits in a detailed manner. It will save you from the last-minute trouble that you might face when getting the treatment. It will give you a clear idea of what your group health insurance covers and what it does not.

Make a List of Network Hospitals

Every insurer collaborates with select hospitals across India that offer cashless treatment to customers in a medical emergency. These are known as network hospitals. You don’t need to make any payment if you are getting the treatment in one of the network hospitals. You should know about the list of network hospitals in your city so that you don’t face any trouble later. To know the same, you can visit the official website of the respective health insurance company.

Keep Your Family Updated About the Policy Details

You must do this due diligence to ensure a successful claim. So in case you get hospitalized, your family members should have all the necessary information related to the group health insurance policy. They should also know the location where you have kept the policy documents so that your family can easily access the same. You can also email the digital copies of your policy documents to your family members as an additional measure.

Let’s Understand the Process to File a Group Health Insurance

In case of a medical emergency, try to get admission to a network hospital as it will help you get a faster cashless claim. Your family will complete all the formalities related to the claim process. After getting discharged from a network hospital, treatment expenses will be sent to the respective insurance company or TPA. After evaluation of the costs, the insurer will settle the claim.

You should also inform the dedicated help desk of your company or TPA to get the required help on the claim process, its approval and required documents.

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