Maternity insurance claim process: Steps and documents required
Understanding the maternity insurance claim process can help policyholders prepare for pregnancy and childbirth-related medical expenses. This guide explains cashless and reimbursement claims, the steps involved, commonly required documents and key considerations before filing a maternity insurance claim
Maternity insurance is a type of health insurance that covers pregnancy and childbirth-related expenses. It supports couples with hefty medical expenses during a pregnancy.
However, before buying maternity insurance, couples need to understand various nuances associated with it. One such nuance is the maternity insurance claim process.
By understanding the claims process and the required documents, you can ensure a hassle-free experience.
Steps to File a Maternity Insurance Claim
The best health insurance in India with maternity coverage offers a smooth, hassle-free claims process. Couples and individuals can file a cashless or reimbursement claim. Let us understand both processes in detail.
Cashless Claim for Maternity Insurance
- Step 1: Inform the insurance provider of the planned hospitalisation within the specified timeframe before admission.
- Step 2: Provide the necessary documents, such as a health card, pre-authorisation form, policy document and more, at the hospital help desk.
- Step 3: The hospital will submit the pre-authorisation form and other documents to the insurer or TPA for approval.
- Step 4: The insurer will verify the document and, based on that, will approve or deny the cashless claim request.
- Step 5: Once the cashless claim is approved, the hospital can proceed with the delivery and related medical treatment.
- Step 6: The insurer will directly settle the covered medical expenses with the hospital.
Reimbursement Claim for Maternity Insurance
- Step 1: Inform the insurer about the hospitalisation within the specified time frame. Delayed notification can complicate the claim settlement process.
- Step 2: Take medical treatment in any authorised hospital of your choice and pay all the medical bills.
- Step 3: Collect all the original receipts, medical bills, diagnostic test results and more.
- Step 4: Fill out the maternity claim form correctly. Submit all the bills and claim forms to the insurance provider.
- Step 5: The insurer will review the claim form and supporting documents and, based on that review, approve or deny the claim.
- Step 6: If the claim is approved, you will get the claim settlement amount directly into your bank account.
Documents Required to File Maternity Insurance Claims
Here is the list of documents you need to submit for maternity insurance claims:
- Health insurance policy document or insurance card
- Duly filled and signed claim form
- Doctor’s prescription and consultation records
- Diagnostic test reports, including ultrasound scans and laboratory test results
- Hospital admission advice or recommendation letter from the treating doctor
- Original hospital bills and payment receipts
- Itemised medical expense bills
- Discharge summary issued by the hospital
- Pharmacy bills and prescriptions for medicines purchased
- Identity proof of the insured person
- Bank account details and cancelled cheque
- Any additional information required by the insurance provider
Smooth Claim Settlement with TATA AIG Maternity Insurance Plan
Understanding the maternity insurance claim process in advance can help ensure a seamless experience during pregnancy and childbirth. TATA AIG offers health insurance with maternity coverage designed to provide financial support for pregnancy-related medical expenses.
It allows families and couples to focus on what truly matters, i.e., childbirth, without worrying about medical expenses. With access to cashless treatment facilities, wellness programs and a streamlined claim process, TATA AIG aims to make maternity care more convenient and stress-free.
