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Tips and Trick health Insurance claim For Policyholders


Many do not know that health insurance this will be very beneficial if taken in while still healthy.

Since most health insurance will be denied the claim when it reported a history of the disease that has already obtained before having health insurance.

Insurance eventually owned so less beneficial or not can be maximized.

It is necessary to note that the filing of claims by participants insurance, insurance acceptable to the health insurance if a disease that claimed to have never suffered by you prior to making insurance.

Because if the opposite, then the auto insurance company will not accept your submission, although medical checkup has proven that you do not currently have any disease that you claim.

As for some health insurance policies generally, stipulate the General provisions as follows

In this provision, the health insurance policy will not bear or cover the cost of treatment of diseases that already suffered before becoming a health insurance policyholders.insurance company

For example, before registering as a health insurance policy holder you already have a high blood disease.

Thus, health insurance will not accept your high blood disease claims if at any time a relapse.

more details, some of the conditions that fall into the category of Pre-Existing Condition:

“That already exists or has existed”

These conditions already described above, whereby these insurance policyholders have a history of a disease that never happened

or has been owned before becoming a health insurance policyholders.

“The cause of the disease known or ever known”

“The cause of the disease” in question is a factor that can affect the incidence of the disease on the health insurance policyholders,

or already there are symptoms that can trigger certain diseases.

for example, you have disturbances such as dizziness, shortness of breath, chest pain, and cold sweats and

nausea which may refer to one of the specific diseases, namely cardiovascular disease.

Therefore, if after you become an insurance policyholder then suffered heart disease, then the health insurance policy will reject your claim-related heart disease.

This is because You have the causes of heart disease before becoming a health insurance policyholders.

In addition, laboratory test results or other investigations which can be used as evidence of authentic description of the condition of the health insurance policyholders have certain conditions or the possibility of the disease,

before the date of the issuance of an insurance policy health or the date the changes clause, taken date most recently.

1.30 day waiting period (All)

Health insurance policies have a provision that policyholders cannot make a claim for the same disease within 30 days after the first disease claims filed.

This applies if the disease suffered by health insurance policyholders are given the care or treatment by the hospital with the patient into inpatient at the hospital.

If the care or treatment is done by way of an outpatient without hospitalization, conditions the 30-day waiting period does not apply.

In other words, health insurance policyholders can claim the same disease three days after the filing of the first disease claims equal or

upon a suggestion of the doctor affidavits/when to return to the doctor for the control the progression of the disease.

health insurance policyholders can claim different diseases at an unspecified time. In a sense, it can claim back the different diseases on the same day.

For example, you claim the flu illness in the hospital, at that time also you can claim a disease/disorder high heat/fever on the day/time.

  1. Waiting period 12 months (Specific Disease)

For specific diseases, health insurance policy stipulates a waiting period of 12 months or 1 year.

Care or treatment is usually done by means of hospitalization due to special handling to the patient the patient recovered.

17 special diseases until now designated as special diseases by all health insurance policy, among other things:

  • All types of hernias
  • All types of tumor/lump/cyst/cancer
  • Tuberculosis
  • Endometriosis
  • Haemorrhoids
  • Diseases of the thyroid gland or tonsils
  • Abnormal condition of the nasal cavity, nasal septum, or clam nose, including sinus
  • Diseases of the thyroid gland
  • A hysterectomy (oophorectomies)
  • Heart disease and blood vessel (cardiovascular) including all types of stroke
  • Hemorrhoids and fistula in anus
  • Stone common bile duct system
  • Kidney stones, urinary tract or bladder
  • Cataracts
  • Ulcers of the stomach or duodenum
  • All types of disorders of the reproductive system, including fibroids in the uterus mom/
  • Intervertebral disc prolapse
  • Tell honestly health conditions

A clause in the policy, the insurance company usually sets out the following conditions:

“In terms of the giving of the information, statements, or explanation in the letter of request for life insurance/health

and/or Insurance request form For a dependent Candidate Data and/or change proposed Policyholders, there is an element of deception and/

or forgery then the Insurer has the right to refute the truth of the policy at any time so that it reserves the right to cancel Coverage ”

From the above statement, the insurance company reserves the right to cancel claims of policyholders of insurance

if there is proof that the lies get information about the health condition of the health insurance policyholders.

Therefore, you should provide the information correctly to any health insurance

so that no unwanted incidents such as the cancellation of a claim that you submit.

The loss is on your side since the insurance premium cannot restore you have given to the health insurance company and instead,

your health is secured by health insurance.

Understand The Risks Of Insurance Filing

From the description at length above, it can be concluded that the claim has medical insurance likely

rejected due to evidence that may be submitted by parties,

such as the insurance claim disease that has suffered before becoming a health insurance policyholders.

Basically, insurance wanted a healthy participant. Due to the risk as an insurance company is to bear the costs of the treatment/care health insurance policyholders.

There will be a possibility that the cost of care/treatment health insurance policyholders is greater than the premiums paid by policyholders of this insurance.

Thus, insurance companies also do not want to accept the prospective participants with an unhealthy body condition.

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