If anyone goes for a claim, cashless or reimbursement,
He has to intimate the claim the insurance company on the toll-free no
with complete information.
In cashless and big hospitals, a separate desk of claim process is there, so they take care of all these things.
If you have a planned hospitalization, you must intimate in advance to the company.
But after all, information taking company will do an investigation and then only
they sanction/ accept the claim.
Will be some insurance policy as the policy planner, insurance bazar, compare online by and save tax.
Claim intimated and claim accepted are different. For accounting purposes, it is treated as an outstanding expense in the books of an insurance company.
An insurance company is involved with the business of covering the risk of an insured person. The insured pays a premium and in return, the insurance company agrees to pay a promised amount (sum assured) on the happening of an event.
The sum assured is called claims. The claim is paid if any of the following events happen:
- On the maturity of the policy, in other words when the term of the policy ends, or
- On the death of the policyholder.
On the happening of the above-mentioned event, the insured person or the family member informs the insurance company that the claim is due on the policy. This is called claims intimated.
The insurance company has to go through the formalities of investigating the validity of the claim made, before accepting the responsibility of paying the amount. This is when we term it as claims intimated but not accepted.
In due course, claims intimated may be accepted by the company. However, the amount is not yet paid and is still due to the insured. This is termed as claims intimated, accepted but not paid.
- Claims intimated,
- claims intimated but not accepted and
- claims intimated and accepted but not paid
are treated as outstanding claims in the books of the insurance company
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