Do senior citizens have to wait longer for their health insurance claim settlement

Do senior citizens have to wait longer for their health insurance claim settlement  14th October 2022

Health insurance policies are a useful tool to tide over any medical contingencies. It is essential for people of all ages, especially senior citizens, to purchase individual or family health insurance that can cover expenses incurred due to hospitalisation or any other allied medical costs. Its importance is only increasing as the medical inflation trends in India increase each year.

We know that age increases the risk of hospitalisation and medical expenses. This creates the necessity to purchase the best-suited comprehensive plan for senior citizens in the family. This article discusses the ideal period for filing a senior citizen’s claim and the time it takes to settle.

The ideal period for filing health insurance claims:

The period of filing the claim is essential in determining the time it requires for processing. Therefore, one must take all the necessary measures to facilitate a speedy claim settlement to benefit from the insurance policy.

Ideally, the insured should file their claim within two weeks for reimbursement claims. This is not a general time frame, as different policies have different time limits. However, claims filed after two weeks of hospitalisation are likely to be rejected or settled later, depending on the case.

Average health insurance claim settlement time:

As per the surveys and research done by the insurance industry, health insurance claims made by senior citizens take 28 days to settle compared to claims made by policyholders younger than 60 years, which take 23.2 days. These results have stirred up interest in the discussion to find the cause behind the delay.

The surveys also state that even the proportion of claim settlements is lower concerning specific conditions like diarrhoea, cancer, or prostate enlargement. However, it is the opposite when related to coronary heart disease. While this may seem alarming to those who have purchased health insurance in India for parents over 60 years, there are simple ways to avoid this.

1. What causes the delay in claim settlement for senior citizens?
The primary cause for the delay in claim processing is the delay in filing a claim. It is essential to ensure that the claim is filed and processed at the earliest opportunity. The findings state that senior citizens may take a while to file claims for numerous reasons, which may cause delays. To avoid late results, senior citizens must file a claim within a week or two and get assured of timely action.

2. A simple tip to ensure timely claim settlement:
It is often seen that young adults purchase health insurance in India for parents not just to protect them from bearing the burden of substantial medical bills but also to file for tax deductions.
However, to claim its primary benefit, it is essential to file claims on time. Since the elderly may require more time to do so, help from the hospital, staff, or relatives to file the claim in time will ensure that it is settled within 23.2 days instead of 28 days.

Carefully read the terms and conditions of health insurance in India for parents that specify information dedicated to senior citizens about the different inclusions and exclusions of the policy. Since medical bills and the risk of falling ill are greater at older ages, it is necessary to be fully aware of the benefits of different policies and file claims within the stipulated period. Help the senior citizens with a good life and healthy well-being!

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Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.