Documents required for buying & claiming health insurance

Health insurance is an extremely useful tool used by many people to navigate through a medical crisis. Since the process of buying and/or claiming insurance is a little complicated, you may get confused and wonder “What are the documents required for health insurance?”

Here’s a rundown of the health insurance documents needed for purchasing a plan and settling claims.

Documents required for buying medical insurance

At the time of purchasing health insurance policy, the insurance company will likely ask you for the following set of documents to process your application. It is important to provide accurate and updated information as both parties (the insurer and the insured) will be entering a contractual financial agreement.

• Proof of identity

As mentioned above, medical insurance policy is a contract between two parties. Insurance providers ask for a valid proof of identity to maintain the authenticity of the contract. The purpose of collecting this health insurance document is to prevent any foul play.

Documents such as a passport, an Aadhar card, a voter ID, and a driving license are widely accepted as proofs of identity.

• Proof of age

Since most health insurance policies have an age-based eligibility criteria, this is one of the most important documents required for health insurance. Health insurance documents that are accepted as valid proof of age are mentioned below:

1. Aadhaar card
2. Driving license
3. Voter ID
4. Passport
5. Birth certificate
6. PAN card
7. 10th or 12th standard mark sheet

• Proof of address

Health insurance documents that provide proof of address are collected by insurance providers to establish trusted communication as they frequently send mails about important updates through post or digitally.

If you move elsewhere, you should update your insurance company about your new permanent/temporary address. Following is a list of acceptable documents for address proof:

1. Aadhaar card
2. Telephone or electricity bill
3. Ration card
4. Rent agreement
5. Passport
6. Driving license
7. Voter ID

• Passport-size photograph

Medical insurance providers ask for latest passport-size photographs of all applicants for their internal verification process. Some insurance providers have gone digital and ask for digital images instead.

• Medical reports

Insurers ask an applicant to provide a detailed medical history along with a basic health check-up to assess the current status of the applicant’s health.

Few insurers may demand additional documents along with a duly filled proposal form. If the chosen plan provides coverage for your family members, then the documents of your family members will also be needed to process the application for a floater/family plan.

Documents required for claiming medical insurance

Insurance companies ask for documents to check the integrity of a claim request, and the claim is settled only after confirming the information’s authenticity.

There are two ways in which you can raise a claim request—cashless claim and reimbursement.

• Documents required for cashless claim settlement

Health insurance documents mandatory for cashless claim include a duly filled pre-authorisation/claim form and a health card provided by your insurer. Cashless claim settlement is a simple process as it does not require you to do much when you avail medical treatment at any of the network hospitals (list of which is shared by your insurer).

• Health insurance documents for reimbursement claim

When you pay for the medical treatment and raise a claim request later, you need to provide the following set of documents along with a duly filled claim form:

1. Valid identity proof or health card provided by your insurer
2. Doctor’s consultation forms
3. Investigative and diagnostic reports
4. Medical bills and receipts
5. Original pharmacy bills
6. Original discharge summary
7. Medico-legal certificate (MLC) or first information report (FIR, applicable in case of an accident)
8. Additional documents as requested by the insurance provider to support the authenticity of your claim

You may need to get the documents (medical bills and receipts) validated by the hospital. Make sure to keep a copy of all the documents with yourself as well at the time of submitting your claim request.

Final word of caution

Health insurance documents include crucial information about you. Hence, it is important that you take utmost care while submitting documents such as Aadhar card, PAN card, voter ID, and passport to any insurance provider.

Mention the purpose of sharing personal information in the application form to safeguard yourself from fraud and/or identity theft.