by lucy77 » Tue Apr 14, 2009 06:28 pm
My husband already joined Prudential health insurance for two years. We never use the insurance so far. But some of our friends telling me that they have difficulty in claiming their health insurance (they're not using Prudential).
The insurance need many proofs and it's seem that the insurance making the process difficult in order to reject the claim.
What proof do we have to provide before claiming for a health insurance ?
The insurance need many proofs and it's seem that the insurance making the process difficult in order to reject the claim.
What proof do we have to provide before claiming for a health insurance ?
Posted: Wed Apr 15, 2009 04:16 am Post Subject:
Hi Lucy, welcome aboard :) Whether or not you'd face problems with claims depend largely upon the company and its claim department. There are insurers who would work for the benefits of their customers and therefore rank high in customer satisfaction. The state department of insurance maintains record of customer complaints against a certain insurer which you can check to see where your insurer is ranking.
~Jeremy
Posted: Wed Apr 15, 2009 04:48 am Post Subject:
For the claim you’d be required all the documents that would support your claim. Ask for receipt for all the services that you would receive from the doctor. Always try to get customized receipts.
You are required to enclose the receipts of the services with the claim form. If you can’t document a particular service that you have received from the doctor the insurer most likely wouldn’t cover it.
Most of the claim forms are easy to fill-out. you may have to provide your insurance information in it along with the reasons to seek treatment.
Hope this helps. If you have more queries, pls don't hesitate to ask the community.
Thanks,
Rupert
Posted: Wed Apr 15, 2009 07:23 am Post Subject:
Hi,
For the claim you’d be required all the documents that would support your claim.
I guess that's the same with all the carriers and your's is no exception. Would you care to mention any document that they shouldn't have asked for? I'm sure, under the current downturn all the insurers would be eager to save their pockets.
Steven
Posted: Wed Apr 15, 2009 11:59 pm Post Subject:
so better get a document from the doctor on time as there appear many new and strange problems that you need to face.I once faced it because the doctor said he will send the documents to the insurance company and he did not at that time.
So this caused my payment delay and i had to pay fined for that.So better collect all the documents on time and keep them properly so that you will not have to waste more time for finding them at the time of need.
Posted: Thu Apr 16, 2009 08:30 pm Post Subject:
I know what you feel Shadowking. You speak on behalf of the consumer.
I wish that the insurance company and agent will be more helpful as they were when they offering us an insurance to apply.
Posted: Fri Apr 17, 2009 06:09 am Post Subject:
So this caused my payment delay and i had to pay fined for that.So better collect all the documents on time and keep them properly so that you will not have to waste more time for finding them at the time of need.
Pay fine :? to whom? If the doctor's office has failed to file the claim on time they are often not allowed to send the bills to the customer.
The insurers are required to cover you for the conditions you have paid the premium for but they also have to follow certain guidelines regarding claim payment. The insured is also responsible for knowing the coverage available to him and therefore should read the policy document to avoid confusions in the future.
Posted: Fri Apr 17, 2009 06:00 pm Post Subject:
well, if i am not mistaken, to claims your medical claims, is not that hard. My country normally we will pass to our insurance agents to settle all the neccessary procedures, and we will just need to sign on it.
If without help for insurance agent, you will just to keep all your medical receipt, and go to your insured company claiming department and fill out the claiming form with those policy details and receipts. wait for their instruction and it is all done. Of course you will have to wait for them to pay back the amount to you.
Posted: Fri Apr 17, 2009 09:48 pm Post Subject: Getting your claims paid
Hi there.
In getting your claims paid by any insurance company, realize that they are looking back 5 years to see if you lied to them about pre-existing conditions. You will need proof otherwise they will return your preemiums.
I have been licensed since 1996 and if someone has a pre-x, I put them in a policy that takes them....ie. Group Insurance.
Call me if you need a mentor...Grant 561 420 6265
or Poweragents[at]gmail.com
Posted: Mon Apr 20, 2009 05:54 am Post Subject:
Thanks,
I see that if we actually have a valid proves, we don't have to worried about our claim. Is it also depend on how reliable our agents to settle this claim ?
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