CLAIM SETTLEMENT PROCEDURES
![Is your medical claim stuck? Find out why you face problems in health insurance claim settlement and how to avoid them](https://img.etimg.com/thumb/msid-111183310,width-100,height-75,resizemode-4/wealth/insure/health-insurance/is-your-medical-claim-stuck-find-out-why-you-face-problems-in-health-insurance-claim-settlement-and-how-to-avoid-them.jpg)
Is your medical claim stuck? Find out why you face problems in health insurance claim settlement and how to avoid them
While health insurers can sometimes be blamed putting customers through unending hardship in clearing claims, many a times it’s the policyholder who is at fault. A significant portion of these health insurance claim rejections can be prevented by asking the right questions during policy selection, carefully reviewing policy documents, and conducting thorough research. This article explores common health insurance claim rejection scenarios and explains how to avoid them.
![6 questions to ask while buying a health insurance policy to avoid claim rejections later](https://img.etimg.com/thumb/msid-111183880,width-100,height-75,resizemode-4/wealth/insure/health-insurance/6-questions-to-ask-while-buying-a-health-insurance-policy-to-avoid-claim-rejections-later.jpg)
6 questions to ask while buying a health insurance policy to avoid claim rejections later
How to buy the right health insurance policy that will pay for your claims on time? You can avert claim rejections by asking the important questions at the time of buying health insurance and reading the policy details and fine print carefully. Ask these questions while purchasing a health plan or at the time of filling a proposal form.
![Up to Rs 10 lakh relief in train accident: How a 45 paisa IRCTC travel insurance can be a huge help for your family in case of death or disability](https://img.etimg.com/thumb/msid-111157563,width-100,height-75,resizemode-4/wealth/insure/up-to-rs-10-lakh-relief-in-train-accident-how-a-45-paisa-irctc-travel-insurance-can-be-a-huge-help-for-your-family-in-case-of-death-or-disability.jpg)
Up to Rs 10 lakh relief in train accident: How a 45 paisa IRCTC travel insurance can be a huge help for your family in case of death or disability
IRCTC travel insurance: Do you know that IRCTC offers an optional travel insurance policy at just 45 paisa premium per passenger. This policy offers coverage up to Rs 10 lakh in cases of death and permanent disability. God forbid if you perish in a train accident, atleast your family will get the required financial assistance.
![Motor insurance rule change: No arbitrary claim rejection, quicker claim settlement, pay as you drive option must, says IRDAI](https://img.etimg.com/thumb/msid-110907614,width-100,height-75,resizemode-4/wealth/insure/motor-insurance/motor-insurance-rule-change-no-arbitrary-claim-rejection-quicker-claim-settlement-pay-as-you-drive-options-must-says-irdai.jpg)
Motor insurance rule change: No arbitrary claim rejection, quicker claim settlement, pay as you drive option must, says IRDAI
Motor Insurance New Rules by IRDAI: The Insurance Regulatory and Development Authority of India (IRDAI) has updated the master circular clarifying important rules for motor insurance policyholders. The regulator has proposed the implementation of strict timelines for claim settlements of auto insurance policyholders. It is a crucial step towards improving efficiency and customer satisfaction. Another key change is the introduction of a customer information sheet (CIS) for auto insurance policies to enhance customer awareness.
![NHCX, a single portal for all health insurance claims soon: what is the claims process, benefits to policyholders](https://img.etimg.com/thumb/msid-110608685,width-100,height-75,resizemode-4/wealth/insure/health-insurance/nhcx-a-single-portal-for-all-health-insurance-claims-soon-what-is-the-claims-process-benefits-to-policyholders.jpg)
NHCX, a single portal for all health insurance claims soon: what is the claims process, benefits to policyholders
The digital platform, to be launched in 2-3 months, will speed up and standardise claim settlement process, leading to cost benefits for the insured.
![Cashless claims to be cleared in 3 hours](https://img.etimg.com/thumb/msid-110608461,width-100,height-75,resizemode-4/wealth/insure/cashless-claims-to-be-cleared-in-3-hours.jpg)
Cashless claims to be cleared in 3 hours
Irdai has also mandated the insurer to decide on the cashless authorisation within one hour of receipt of the request.
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Health insurance premiums can be reduced if you don’t make a claim, policy cancellations to be less costly and more: 5 rule changes
Health insurance rule changes: To make health insurance policy more inclusive, flexible and customer-friendly, IRDAI has recently released a master circular on health insurance business. The regulator introduces new measures regarding cancellation charges, standardising no-claim bonus, and increasing claim settlement transparency. ET Wealth Online explores how these regulations empower policyholders and improve their health insurance experience.
Health insurance claim rule change: Cashless claims must be cleared in 3 hours; insurer to pay hospital charges for delay in discharge, says IRDAI
Health insurance: The Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular to streamline health insurance claim process. Previously, delays in claim approvals forced patients to stay in hospitals longer. Now, insurers have three hours to approve cashless discharge requests. Additionally, insurers will be liable for extra hospital charges due to delays.
IRDAI in favour of 100% cashless claim settlement in health
In terms of cashless claims, the regulator wants insurers to decide on authorisation requests within one hour of receipt. It has directed insurance companies to put in place necessary systems and procedures to meet the new guidelines by July 31, 2024.
Major changes in insurance regulations — new health insurer Galaxy Health, Bima Sugam, more protection for policyholders
IRDAI has approved eight principle-based regulations at its recently held board meeting. The primary ones include Bima Sugam — an online marketplace for insurance policies, product regulations regarding the surrender charges of the insurance policies, and regulations for the protection of policyholders. All you need to know
EPFO issues SOPs for handling joint declaration application for higher pension under its Employees’ Pension Scheme
The retirement fund body EPFO, on Monday, issued the standard operating procedures (SOPs), listing out the valid documents for correction in employees’ profile while fixing timelines for processing the correction-related applications and allowing subscribers to online monitor their application.
LIC customers: How to file maturity claim for LIC policy to get your money
LIC customers have the option to electronically submit their documentation via the LIC site instead of physically submitting it. LIC is urging policyholders to update bank details and submit KYC to receive policy money.
Latest EPFO rules: How to unblock inoperative EPF account, settle claims
The EPFO has especially outlined the procedural complications involved in UAN generation/linking, KYC seeding, blocking, unblocking, and paying claims for transaction-less accounts and inoperative Accounts. Let us take a look at what the EPFO SOP had to say about inoperative accounts.
Health insurance rule change: Cashless treatment at any hospital from today; how to get it, charges
Till now, a health insurance policyholder can get cashless treatment only at network hospitals with whom the insurance company has tied up. If it is a non-network hospital, the policyholder has to pay the entire amount from his pocket and then go through the cumbersome claim reimbursement process. The General Insurance Council in consultation with general and health insurance companies has launched 'Cashless Everywhere' to extend the cashless treatment at all hospitals. What is the new rule? How to get cashless treatment at any hospital? Know here
Chances to reach consensus on WTO dispute settlement body reforms 'low' in next meet: GTRI
WTO member countries are unlikely to reach a consensus on reforming the dispute settlement system at the upcoming ministerial conference (MC). The differences between developed and developing countries over the issue pose a challenge.
New health insurance rule in 2024: CIS will show claim settlement time, other key policy details from January 1
A customer information sheet or CIS gives you a glance at the key policy details in a summarised format. The Insurance Regulatory and Development Authority of India (IRDAI) has asked insurance companies to provide revised customer information sheets (CIS) highlighting all key policy details in simple terms from January 1, 2024. Know how it will help health insurance policyholders
Navigating the general insurance landscape: A reflective review and forward outlook
The GI industry is entirely focused on achieving the glorious mission of 'Insurance for All' by 2047, set by the insurance regulator.
National Lok Adalat: Here's how you can settle your traffic challan by paying less tomorrow
National Lok Adalat Dec 2023 Date: These Lok Adalats are structured to handle various matters, including civil, minor criminal, family, property, labor, bank loan, revenue, forest, motor accident claims, and cases related to challans or e-challans. Their objective is to offer a simplified and efficient approach to resolving pending legal disputes.
Apple agrees to $25 million settlement with US over hiring of immigrants
The Justice Department in a statement said Apple did not recruit US citizens or permanent residents for jobs that were eligible for a federal program allowing employers to sponsor immigrant workers for green cards, in violation of a federal law that bars discrimination based on citizenship.
Health insurance claim-settlement time, coverage, key details to be available in single, easy-to-understand document from January 1, 2024
Understanding your health insurance policy is set to become easier as IRDAI has asked insurers to provide updated customer information sheets (CIS) with health insurance policies, starting from January 1, 2024. The CIS is designed to provide policyholders all important information about their health insurance policy in simple language in a snapshot, said the insurance regulator. Know how your health insurance CIS will look and how it will benefit you.
Health insurance claim got rejected? Here's what you need to do now
Most of the policyholders regularly pay their health insurance premium hoping that one day this policy will rescue them if they face any medical emergency. However this moment of truth turns into a bitter experience if your claim is rejected. Here is what you can do to make sure that your rightful claim is honored to your satisfaction.
Health insurance policyholders to get claim settlement time, coverage, limit, key details in single document: IRDAI proposes
Now, the Insurance Regulatory and Development Authority of India (IRDAI) has suggested changing the existing format of the customer information sheet. The new format of customer information sheet will ensure that policyholders receive all of the basic information regarding the coverage. If finalised, it will further help policyholders understand the complex terms and procedures related to their health insurance policies better, say experts. Let's take a look at the key changes in the proposed customer information sheet of health insurance policies.
Cyclone Biparjoy: Insurance claim payments to be disbursed at the earliest, says Irdai
In order to expedite the settlement of insurance claims in all states impacted by storm Biparjoy, the Insurance Regulatory and Development Authority of India (IRDAI) has requested life insurers to take the appropriate actions.
Odisha Train Accident: EPFO relaxes norms for EDLI, pension claim, suggests alternatives to death certificate
The competent authority has decided to relax the necessity of a death certificate for EDLI and pension claims relating to deceased members who lost their lives in the train accident in Odisha in order to lessen hardship for family members.
Irdai instructs insurers to ease, expedite claims settlement for victims of Odisha train accident
Insurance companies must abide by rules set forth by the Insurance Regulatory and Development Authority of India (Irdai) when resolving insurance claims for those hurt in the recent train disaster tragedy in Balasore, Odisha.
Life certificate submission at any branch, online deposit claim settlement: RBI committee's major recommendations
The Reserve Bank of India (RBI) organised a committee last year to investigate the customer services provided by RBI-regulated enterprises (RE) such as banks, non-bank financial firms (NBFCs), and payment service operators.
US, chipmaker Micron settle claim of immigration-related discrimination
Micron will pay a civil penalty to the United States and offer back pay totaling $85,000 to the affected worker, according to the settlement details. The amount of the civil penalty was not specified in the Justice Department statement.
Death claim settlement rules for post office schemes like PPF, Sukanya Samriddhi, NSC
The government has made changes to the process of claiming money from several post office small savings plans in a circular dated August 28, 2020 shortening the process.
PNB locker claim settlement: How claims settlement will work after death of locker hirer
PNB has a simplified policy and procedure in place to help with the settlement of claims for deposits, locker contents left in the accounts of the deceased.
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