Writing letters for health insurance claim settlement to insurance companies or third party administrators is and old but authentic and proper way for claim intimation.
Although in this digital era things have improved a lot to the extent of claim survey and settlement through video calls, there are many other means as well of claim intimation for instance through the medium of tele calling, mobile application and the worldwide web, letter writing has its own importance in this case as there is proper physical record of the claim intimation done and all the relevant documents can be attached to the letter itself for better clarity and understanding of the insurer.
Also in remote areas, villages and tier two cities not everyone of any age is so tech savvy and digitally competent to properly intimate claims to insures through new and innovative means, here letter writing comes to rescue. In this current article we will explain the nuances of writing a hospitalization indemnity insurance claim letter for COVID 19.
COVID 19 or the novel corona virus pandemic has took the whole world on stride. Starting initially from China, Any country in this world was not left from its devastation and destruction.
Although stringent measures of complete lockdown was implemented by the government some part of which continues even till today, the disease got spread rapidly in India with millions of people getting contracted by the virus.
The second wave was more disturbing than the first one regarding number of lives lost and clearly depicted the unbearable stress on our medical infrastructure as people struggled to get appropriate medical attention.
There was acute shortage of oxygen in hospitals, dearth of hospital beds, over occupied doctors and medical staff and what not. Insurance regulatory and development authority of India (IRDAI) the regulator was quick enough to act in this matter and issued guidelines to all insurers regarding adherence and implementation of COVID claims.
Two different types of indemnity and benefit based COVID products were seen in market launched by a selected few public and private insurance companies although many of these were on pilot basis and discontinued later due to high frequency of claims.
COVID claims has severely hit the life and health insurance companies with claims settled approximately 15.5 Lakhs in number. As the deadly menace is not over yet and people may need to present a claim systematically to the insurance company.
Concerned to this subject, below is a sample of a general claim intimation letter for COVID, the reader may get an overview of writing the same and should include the specific details on a case to case basis.
Health Claims Department,
XYZ Insurance Company,
ABCDEF Road, Banka Colony, New Delhi 110001
Subject: Intimation of COVID 19 hospitalization Claim from 19-09-2021 to 28-09-2021, under product name – Corona Raksha (UIN – XX547768152), Policy Number 7755413287.
This letter is to inform you and bring to your kind notice about the hospitalization claim with respect to COVID 19. Describing the whole incident I want to state that I was feeling unwell with high fever and developed symptoms on 17 September 2021 night for which and on advice of my family doctor got myself tested for COVID antigen and RT-PCR.
When I received the reports I came to know that I was COVID positive on the reports shared by a nearby authorised pathological lab. For your kind information I would also like to highlight here that I never travelled out of the city since the first wave of COVID hit our country and was strictly following all government guidelines and related protocols.
Following the reports and my health situation getting worse, I got myself admitted in AMF Hospitals on 19-09-2021 11: 30 am after much efforts and being denied for a hospital bed by many renowned hospitals due to unavailability, to receive proper medical attention. At the time of admission it was impossible for me and my family to inform this to your company and get cashless facility approved and hence I decided to bare the hospitalization expenses from my own pocket and get it later reimbursed from you. Later my health condition became stable after receiving the treatment and I was finally discharged from the hospital on 28-09-2021 9:00 am after completing all the formalities there.
This is a sincere request to go through contents of this letter and the attached supporting documents to settle my claim amounting 2.34 Lakhs at the earliest. The amount has been calculated after summing up all the eligible hospitalization expenses incurred within the period of 10 days of my hospital stay and deduction of the non medical expenses which is applicable to the policy I purchased from your esteemed company. A cancelled cheque copy of my bank account and the NEFT mandate form duly signed is also attached herewith for your ready reference so that the claim amount can be directly credited to my account.
List of documents attached
- Policy copy
- Claim form duly filled and signed
- NEFT mandate form
- Aadhar card copy
- Pan card copy
- Original Hospitalisation bills
- Cancelled cheque copy
Please let me know if any further documents or information is required from my in substantiating and getting the claim paid. For this I shall remain highly obliged and grateful to you.
15, GHJ Street, New Delhi 110002
Mobile – 9887766575
Email – email@example.com