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Claims Processing Made Easy: Tips on What to Present When Claiming on Your Critical Illness Insurance

Insurance, as they say, is something you buy in case something you don’t want to happen actually happens. So, you really don’t want to have to make a claim, but when the unfortunate happens and you need to make a claim, it will be helpful to know what to do.

Here are simple tips for you to remember:

  • Notify the insurance company immediately about your diagnosis.

    Giving them a heads up will help facilitate the claims process.

  • Keep all your medical records.

    When you make a claim, you will need to submit your medical records and it will be helpful if these medical records are complete. These include:

    • Your doctor’s report
    • Laboratory reports
    • Receipts of medical expenses
  • Know the definition of the critical illness as listed in the policy.

    The different serious illnesses may have varying definitions with different policies, so read about how they are covered in your policy.

  • Be detailed and tell the truth.

    Falsifying records and legal forms is an offense and if found out, it can negatively impact the results of your claim. Before the payout, the insurance company will thoroughly check the details of your claim. The same is true for any statements you gave to the insurance company at the time of your application. They will verify these statements and if there are some irregularities, these may cause a denial of your claim.

    For instance, if you said you are not a smoker and then they can prove that you have been smoking at the time of your application; this can affect your claim. In some cases, it may not even matter if the non-disclosure or the false statement is not related to your claim.

  • Expect a lot of correspondence and be willing to answer these.

    Because the insurance company will carefully look at your policy, they may time and time again need to ask questions that are not readily found in your documents. This can be exasperating, but you need to cooperate with the insurance company to make sure that your claim is processed more quickly.

Here is a more comprehensive article with additional tips when making a claim: Dos and Don’ts when making claims

Some documents you may be asked to present when you make a critical illness claim:

  • Your birth certificate, to ascertain your name and age
  • Proof that the claimant has the legal authority to make the claim
    • Original policy (if the Person Insured is the claimant)
    • Marriage contract (if the claimant is the spouse)
    • Birth certificate of the claimant (if the claimant is a child of the person insured)
    • Last will and testament (if the claimant is declared an heir of the deceased person insured)
    • Medical reports and tests

If you are diagnosed of the critical illness while you are abroad, there may be instances where you need to get a second opinion from a Consultant/Specialist practicing in UK or other included country.

Last updated on: 18.1.2013

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