Do you know the main points of critical illness insurance's claim settlement?

Today, let's talk about matters needing attention in critical illness insurance claims:

First, diagnosis

Diagnosis means that when customers have a premonition that their physical condition has signs of major diseases, they usually go to the hospital designated by the insurance company for treatment first. In critical illness insurance claims, this is very mobile. In the process of seeking medical treatment, the hospital will diagnose the physical condition of the customer according to its medical equipment and the actual situation of the customer, and draw the conclusion whether there is a major disease and which serious diseases are specific, that is, the so-called diagnosis. Hospital diagnosis has a confirmation book, which is very important and belongs to the necessary materials for insurance claims.

second, report the case

after the customer is diagnosed with a major illness, he needs to check the policy to see if it belongs to the major illness stated in the policy. In the process of critical illness insurance claims, we should pay attention to the fact that the customer's major illness is basically included in the insurance insured by the customer. Of course, it does not rule out the possibility that it is not included in the insurance policy. Customers need to call the insurance company's customer service number and report to the insurance company, whether before or after hospitalization, that is, they need to report before applying for claims. After receiving the report, the insurance company will start the claim settlement procedure and make claims.

Third, prepare relevant materials

The following materials are generally needed for critical illness insurance claims:

① Diagnosis certificate, outpatient medical records, discharge summary/hospitalization summary; Must be stamped with the effective signature of medical institutions: such as diagnosis chapter, medical department, inpatient department, emergency chapter, etc. You need to provide the diagnosis certificate of multiple hospitals at the same time when you see a doctor in multiple hospitals.

② Medical expense receipt (with prescription), hospitalization expense receipt, detailed list of hospitalization expenses and split sheet must be formal and valid reimbursement invoice receipt with the seal of the national finance and taxation department.

③ The pathological, laboratory, imaging, electrocardiogram and other examination reports that can be diagnosed must be stamped with the effective signature of the medical institution. When the customer has prepared the materials stipulated in the policy, the situation is true, and the insurance company will make claims according to the critical illness insurance claim contract. Therefore, if a customer suffers from a serious illness, as long as he gets in touch with the insurance company quickly, prepares the corresponding materials, and is verified by the insurance company that there are no exclusions, he can get the insurance company's timely critical illness insurance claims.