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Documents Required for Health Insurance

Read in detail about the documents required for health insurance.

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Health insurance is a tool that helps in reducing the financial burden of medical expenses. It can be tremendously useful in a time of medical emergency. Without the support of a health insurance plan, you might quickly run through your life savings and lose quality healthcare. Hence, it is best not to take any chances and know about the documents required for health insurance. 

Documents Required While Buying Health Insurance Plan 

At any stage in your life, it is essential to be prepared for health emergencies. Even when you lead a relatively healthier lifestyle, it is impossible to be completely immune to medical issues. Considering the increased vulnerability to health threats due to several reasons, maintaining financial security is vital.

When you plan to purchase a health insurance plan, you should calculate the adequate coverage first and foremost. According to your age, income, medical condition, you can select the preferable features of the plan. Once you have decided on the policy, the insurer will ask for certain documents required for health insurance.

The documents required for health insurance are to verify the policyholder’s identity, age, and income details. It is important to be careful when submitting the documents required for health insurance. In case there is false information or lack of information found in the future, you may not get the benefits from the policy. 

You need to submit the documents required for a health insurance policy at the time of purchase and claim. Here is the health insurance document checklist you need to remember when buying a suitable plan: 

1. Proof of Identity 

The insurer uses identity proof of the policyholder to maintain records. When you require the benefits of the plan, the given documents are used to verify your identity and provide proper coverage. The acceptable identity proof documents required for health insurance are:

  • Aadhar Card
  • Passport
  • Voter ID Card
  • Driving License

2. Proof of Age 

One of the essential documents required for health insurance is the age proof of the insured. For this, you can submit any of the following documents:

  • Aadhaar Card
  • Pan Card
  • Passport
  • Driving License
  • Voter ID Card
  • Birth certificate

3. Proof of Address 

At the time of purchase, the address proof is one of the essential documents required for health insurance. It may be used as the postal address by the insurer for communicating with you. Here are a few documents you can provide as address proof:

  • Driving license
  • Ration Card
  • Aadhar Card
  • PAN Card
  • Passport
  • Rent agreement, if applicable
  • Utility bills like electricity bill or telephone bill

  • Aadhaar Card
  • Pan Card
  • Passport
  • Driving License
  • Voter ID Card
  • Birth certificate

3. Proof of Address 

At the time of purchase, the address proof is one of the essential documents required for health insurance. It may be used as the postal address by the insurer for communicating with you. Here are a few documents you can provide as address proof:

  • Driving license
  • Ration Card
  • Aadhar Card
  • PAN Card
  • Passport
  • Rent agreement, if applicable
  • Utility bills like electricity bill or telephone bill

 

4. Other Important Documents 

Apart from the ones mentioned above, here are some other important documents required for health insurance:

  • Passport-size photographs (if demanded by the insurer)
  • Medical reports (if demanded by the insurer)
  • Proposal form duly filled in and signed

Along with this health insurance documents checklist, the insurer may ask for other specific documents required for health insurance, if necessary.

Also Read: Documents Required for Term Plan

Documents Required While Filing a Health Insurance Claim 

You also need to submit certain documents at the time of claim to enjoy the benefits of your health insurance. However, the documents required for a health insurance policy during the claim may be different. It also depends on the terms and conditions of your plan. 

For instance, if you are going for cashless treatment, you may not need to submit various documents required for health insurance. The insurer and the network hospital may settle the medical bills directly. 

Documents Required While Filing a Health Insurance Claim 

You also need to submit certain documents at the time of claim to enjoy the benefits of your health insurance. However, the documents required for a health insurance policy during the claim may be different. It also depends on the terms and conditions of your plan. 

For instance, if you are going for cashless treatment, you may not need to submit various documents required for health insurance. The insurer and the network hospital may settle the medical bills directly. 

 

Here’s a list of health insurance claim documents for your reference (documents required might differ from one insurer to another):

  • Duly filled and signed claim form of the insurance company
  • Discharge summary or card of the patient
  • A written consultation from the doctor with receipts
  • Hospital bills, which have to be stamped and signed by the hospital authorities
  • Any test results such as blood test, urine test, X-ray films, and others
  • Prescription bills from pharmacies/hospitals
  • In case of an accidental injury, FIR or Medico Legal Certificate (MLC)
  • Any other relevant documents relating to the cause of treatment

Also, remember to keep a copy of the documents required for health insurance while submitting them. 

Things to Consider at the Time of Buying Health Insurance 

A health insurance plan is responsible for taking care of your future medical bills. On average, up to 10% of annual household consumption[1] is utilized for health care needs. As the healthcare costs are surging every day, it is best to invest in a suitable plan for you and your family.

Checking the documents required for health insurance comes after you have selected the right policy. You should consider a few key things to choose a policy with the best benefits. Let’s take a closer look at them.

1. Adequate Sum Insured 

Make sure that the sum insured of your health insurance plan is enough to cover your particular requirements. If you have any pre-existing diseases, going for a higher sum insured is the wise thing to do. If you end up dissatisfied with the received amount in a time of need, health insurance will fail to serve its purpose.

2. Coverage Limit 

There are different types of health insurance policies that offer varying coverage. For instance, a particular type of medical condition may not be covered by the plan. Therefore, make sure you read the inclusions and exclusions of your health plan before purchase. 

Also Read: Difference Between Health Insurance and Cancer Insurance Plan

3. Network Hospitals 

Insurance providers have a list of network hospitals where they offer cashless treatment. You can choose a health plan by checking this list for easily accessible hospitals. By doing so, you can receive medical treatment far more conveniently. 

4. Claim Settlement Process

An insurer that offers an uncomplicated claim settlement process is an ideal choice for most people. When it comes to health problems, you want to receive quality healthcare promptly. Remember to go through the claim settlement process, including the documents required for health insurance, appropriately. 

3. Network Hospitals 

Insurance providers have a list of network hospitals where they offer cashless treatment. You can choose a health plan by checking this list for easily accessible hospitals. By doing so, you can receive medical treatment far more conveniently. 

4. Claim Settlement Process

An insurer that offers an uncomplicated claim settlement process is an ideal choice for most people. When it comes to health problems, you want to receive quality healthcare promptly. Remember to go through the claim settlement process, including the documents required for health insurance, appropriately. 

 

Steps to File a Health Insurance Claim 

The claim settlement process can be confusing for many policyholders. Mainly, there are some documents required for health insurance claim to go smoothly. Follow these steps to go through the health insurance documents checklist quickly:

Step 1:

The documents required for health insurance claim include medical receipts, bills, and reports. Keep them safe with you and arrange them in chronological order for more efficiency. Also, check if these documents required for health insurance contain necessary information such as patient name, costs, document number, signatures, etc. 

Step 2:

You need to fill a claim form provided by the insurance company. The form is generally available for download from the insurer’s website. Read the instructions carefully and fill the claim form with accurate information.

Attach it to other medical bills and reports to make a set of the documents required for health insurance claim.

Step 3:

You may need to submit the original and copies of the documents required for health insurance. In addition, keep a copy of all the documents required for health insurance policy for yourself.

Step 4:

You must review the documents required for health insurance carefully before submitting them. In case there is a missing document or false representation of details, the claim may not be processed on time or at all. 

Frequently Asked Questions (FAQs)

Q. What Is Waiting Period In Health Insurance? 

A. When you buy a new health insurance policy, there is generally a waiting period of 30 days, during which the insurer does not take any settlement claims. The waiting period starts from the inception date of the policy.

Q. Do I Need to Go Through Medical Tests to Buy Health Insurance? 

A. Yes, the insurer may require a medical examination of the insured individual, depending on the age of entry.

Q. How Many Times Can I Claim My Health Insurance Policy? 

A. You can claim your health insurance policy any number of times unless there is a specific predefined cap. The claims are only restricted by the sum insured amount.

Q. What Is a Health Check Facility? 

A. Some insurers offer general health check-ups once in a few years as part of the health insurance coverage. Check with your insurer to know the details.

Q. What Is A Family Floater Policy? 

A. A family floater policy is a single health insurance plan covering medical expenses for all family members. The policy has one sum insured, which can be used by any member of the family in any proportion, subject to the maximum overall limit of the sum insured. 

Please read terms and conditions of the policy before concluding a sale. Information mentioned may vary. Max life can not be held responsible if any policy purchases made basis aboave information cited.

Sources

https://niti.gov.in/planningcommission.gov.in/docs/reports/genrep/bkpap2020/26_bg2020.pdf (2020)

https://www.policyholder.gov.in/how_to_make_a_claim__health.aspx

https://www.policyholder.gov.in/you_and_your_health_insurance_policy_faqs.aspx

https://www.policyholder.gov.in/Dos_and_Donts_for_Health_Insurance.aspx

ARN No : Aug21/Bg/19B

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