The procedure to claim medical insurance may vary across insurers. For example, while many insurers require claims submission within 30 days that you receive treatment, some insurers allow until 90 days for submission to be made. Other difference may be the documents that insurers require to process your claims. As a general guide, we’ll walk you through the procedure to claim medical insurance.
Cashless vs. reimbursement policy
Medical insurance pays for your hospitalization and medical bills according to your policy coverage. In terms of payment, note that insurers offer cashless policy and reimbursement policy.
For a cashless policy, you don’t have to pay for your medical expenses out of your own pocket. With most cashless policies, you simply have to present your medical card to a panel hospital, and if you don’t have a medical card, you just have to contact your insurer to issue a Letter of Guarantee to the hospital.
For a reimbursement policy, while your insurance will also pay for your medical expenses, the policy requires you to pay for your medical expenses upfront and only then claim for reimbursement.
Let’s get to the procedure to claim medical insurance. All it takes is four steps.
1. Prepare the documents required by your insurer
Typically, these are the documents that your insurer requires:
- A copy of your NRIC/passport
- Original hospital receipts and invoices
- Itemised hospital bills
- Diagnostic reports (e.g. blood test and X-ray)
- For treatment outside of Malaysia, include passport copies, boarding pass, flight ticket details, and original itemised bills
2. Fill in your claim forms
Simply download claim forms from your insurer’s website and fill them in!
But if you can’t find the claim forms online, give your insurer a ring so they can get you the forms.
Note that certain policies also require your doctor to furnish a Medical Examiner’s Statement, which is basically a medical report of your diagnosis and treatment. Not sure whether your insurer needs one? Don’t be shy, just holla your insurer.
3. Review and make copies of your claim forms
Double-check your claim forms and the required documents.
While you’re at it, make a physical or digital copy of each form or document before submitting your claim. You may need them should there be any issues with your claim, so be prepared!
4. Submit your claim
Submit your claim either directly to your insurer through their branch or through your agent.
Some insurers allow you to submit your claim online, so do check with your insurer!
Now sit back, relax, and wait for your money to be reimbursed.
PS: Submit your claim ASAP! Most reimbursement policies require you to submit your claim within 30 days of the incident. So don’t wait too long as your insurance company may not accept your claim!
Medical insurance claim is easy with Bjak
Bjak will handle everything for you when you purchase life and medical insurance at our platform. Our claims assistance is available 24/7, 365 days a week and all claims are handled by claim experts with a cumulative experience of over 50 years.
Secure your all-in-one life and medical insurance here: Bjak
(Sources: iMoney, Persatuan Insurans Am Malaysia, RinggitPlus)
