Health insurance is one of the most in-demand insurance nowadays due to the grave situation is seen by all of us in form of a pandemic.
Even before that, the health insurance sector was booming with a consistent decent CAGR over the last decade but the emergence of COVID 19 made it an absolute necessity for every individual and household to buy.
This emergence has made a lot of people rethink the medical insurance coverage they have currently and many are preferring to buy a new policy if they don’t have a cover in place or increase the sum insured under their existing policy if the cover is seeming insufficient in the view of high medical inflation.
Health insurance is the most basic form that covers inpatient hospitalization which means admission to a hospital for a period of 24 consecutive hours or more. But this is not the end of the story mediclaim policies offered by general and health insurance companies in India today offers a wide range of innovative and useful inbuilt and additional coverages and benefits like pre and post hospitalization, Road and air ambulance coverage, daycare procedures, preventive health check-ups, numerous wellness benefits and many more.
Maternity benefit is a very prominent benefit offered by most of the insurers along with health insurance products which is widely popular among newly married couples. This benefit is generally provided in separate sub-limits for normal and C Section and in addition to delivery expenses also reimburses for pre and post-natal cover, newborn cover, and vaccination expenses.
In addition to the hospital charges like room rent, doctor fee, etc. other costs like medicines are also covered. Some costs like consumables may be excluded from the scope of the policy which is to be noted.
Insurers evolving with time and technology have come up with many innovative and modern ways of intimating the claim. This adds to the value proposition they provide to their customers and provide them with a delightful experience. Most common modern ways of claim intimation under mediclaim policies could be through calling the dedicated helpline, intimation through the web portal and mobile application etc.
Although mostly these goes well with millennials and tech-savvy customers residing in metro and tier-one cities. Less educated, older generation people and rural customers still prefer more traditional ways of communication like writing a letter to inform the claim to the insurer.
Letter writing may be a considered a traditional and orthodox way but it does not necessarily mean that this should not be a preferred way to inform claim to insurance company. This mode of communication for claim intimation can at times save a lot of time and effort both in terms of the customer and the insurer as it provides clarity, is well documented and provides first-hand information to parties.
Proofs and bills can be attached with the letter itself with a succinct and precise description of the whole incident which is a good practice to follow. As per the title of our current article, we will present below a sample maternity claim letter which can be used as a guide by the readers to write benefit intimations to insurers with their exclusive situation and set of documents described therein.
Sample Maternity Claim Intimation Letter
Insurance Company Claims Manager,
XYZ Insurance Company Limited,
11 – Mahajan road, Times Circle, Sion Mumbai
Subject – Maternity cashless claim intimation under Health Saksham policy (UIN No 876548098) (Policy No 23JJ87888) Policy period 01-011-2021 to 31-10-2022.
This is to inform you that I am going to be admitted to XYZ hospital in the vicinity of my home for the cesarean section delivery of my second child on date 02-12-2021. This is the date confirmed by the doctor as I will be completing nine months of pregnancy since then.
The aforementioned hospital is in your network list of hospitals which I have duly confirmed from the pamphlet provided with policy copy and your website as well. For your further information, this hospital is nearest to my home with all the modern treatment facilities available and I was under constant supervision and treatment of renowned doctor Mrs. CM DAN of the same hospital since the detection of my pregnancy.
For your kind notice to reiterate, the C section sublimit in the policy purchased by me from your company is INR 8 Lakh. We have already informed the hospital about the cashless insurance in place and already submitted the required documents at their dedicated insurance helpdesk. They will share the required documents with you to obtain the necessary and required approvals well before my planned admission there.
The room selected by us is well within the room rent sublimit mentioned in your policy document. After the delivery, the hospital will directly share all the required bills and documents with your team to get the reimbursement completed.
This letter is for your early notice and intimation of the claim from our end. It is a sincere request to approve the cashless claim under my policy so that the delivery and related covered expenses can be taken care smoothly.
Documents submitted at Hospital Insurance helpdesk
- Policy copy Xerox
- Aadhar card Xerox
- PAN card Xerox
- Confirmation of doctor for delivery at mentioned date
Mrs ADAN SHYAM
12, Hasan lane, Near Old fort
BCS Street, Nagpur 07009