The Health Insurance Claims Process
This document provides a comprehensive walkthrough of the health insurance claims workflow for both cashless and reimbursement scenarios. It details the required steps for planned and emergency admissions, noting strict IRDAI timelines such as one-hour pre-authorization responses for planned procedures. Furthermore, it outlines the specific documents needed for filing a reimbursement claim within the typical 30-day post-discharge window. The guide also includes a clear escalation path to follow if an insurance company delays the processing of a claim.