Steps involved in filing a Health Insurance Complaint
The steps to be followed while filing a
- First and Foremost important point is that records and copies of all relevant documents should be maintained.
- Make a note of all transactions between yourself (policyholder) and the insurance agent and the insurance company.
- Maintain a file of correspondences in order for easy tracking and retrieval of information.
- Maintain a record of the receipts (from the agent and Insurance Company), policy documents and TPA (Third Party Administrator) cards in order.
- Approach the Customer Care Department and explain them your grievances or disputes regarding the claim. Give the Insurance companies sufficient time or duration to address your doubts and grievances.
- If the policyholder does not feel satisfied with the reply, he/she can elevate this dispute by approaching the Insurance Ombudsman.
- If the outcome at the Ombudsman remains unsatisfactory, it is possible to examine the possibility of taking the legal route i.e approaching the court or the Consumer Forum.
- If the claim amount involved is high, services of a suitable lawyer or an advocate can be taken.
- Remember that negotiation skills and tenacity to overcome the challenges for the sake of your rights are essential for resolving the disputes pertaining to the claim.
- Customer Satisfaction in 7 Steps - (http://articles.sitepoint.com/article/satisfaction-7-steps)
- Have an insurance complaint? Read this - (http://www.rediff.com/money/2004/mar/22perfin.htm)
Please use one of the following formats to cite this article in your essay, paper or report:
Dr. Sameer Sippy. (2020, July 30). Customer Care in Health Insurance Industry - Steps involved in filing a Health Insurance Complaint. Medindia. Retrieved on May 24, 2022 from https://www.medindia.net/patients/insurance/customer-care-in-health-insurance-industry-complaint.htm.
Dr. Sameer Sippy. "Customer Care in Health Insurance Industry - Steps involved in filing a Health Insurance Complaint". Medindia. May 24, 2022. <https://www.medindia.net/patients/insurance/customer-care-in-health-insurance-industry-complaint.htm>.
Dr. Sameer Sippy. "Customer Care in Health Insurance Industry - Steps involved in filing a Health Insurance Complaint". Medindia. https://www.medindia.net/patients/insurance/customer-care-in-health-insurance-industry-complaint.htm. (accessed May 24, 2022).
Dr. Sameer Sippy. 2021. Customer Care in Health Insurance Industry - Steps involved in filing a Health Insurance Complaint. Medindia, viewed May 24, 2022, https://www.medindia.net/patients/insurance/customer-care-in-health-insurance-industry-complaint.htm.