Library of International Medical and Health Insurance Information and Resources

HANDLING CLAIMS

TIPS ON FILING A HEALTH INSURANCE CLAIM
SUBMITTING CLAIMS
CLAIMS – GO DIRECTLY TO INSURER’S “CLAIMS DEPARTMENT”
SPEEDING UP THE CLAIMS PROCESS
KEY TO SHORT-TERM HEALTH INSURANCE CLAIMS.
PAYING CLAIMS – HOW LONG SHOULD IT TAKE?
WHEN YOUR INSURANCE WON’T PAY
HOW COMPANIES DETERMINE “USUAL, REASONABLE & CUSTOMARY”
WHEN YOUR TRAVEL INSURANCE IS YOUR “PRIMARY COVERAGE”
INSURANCE CLAIMS
CLAIMS REIMBURSEMENT--WHY IS IT SUCH A PAIN?
CLAIMS SUBMITTED LATE CAN BE DECLINED

INSURANCE CLAIMS

The wait for reimbursement of an insurance claim always frustrates us. Why does it take so long? In this matter we need to remember that if we take out a "guaranteed issue" policy, a policy where they ask you four or five simple questions before you are accepted for coverage, claims will take longer. The company does the underwriting after you post the claim. They need to make sure your claim has nothing to do with a pre-existing condition.

PPO plans take more time for claims reimbursement because they want to double check to make sure the claim is not based on a pre-existing condition that was not stated in the application.

It's probably good to remember that if an insurance company takes time to research the validity of claims, in the end they are saving you money. Insurance fraud costs insurance companies millions of dollars every year, and we, the insured, pay for those lost dollars through higher premiums. Every time an insurance company can avoid paying an unjustified claim, we are the winners because it helps the company control our monthly premiums. Although that may make us feel better, patience while waiting for a claim to be paid is still a difficult art to master.

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