Claim: meaning in health insurance
เคลมประกัน
A claim is a request to the insurer to pay for covered medical costs, either directly to the hospital (cashless) or as a reimbursement to you.
Two ways to claim
- Cashless: in a network hospital, the hospital claims directly from the insurer
- Reimbursement: you pay and send the claim form, original receipts, itemised bill and medical certificate
Tips
Submit claims quickly: policies set a deadline. Keep copies of all documents. For planned treatment, ask for pre-authorisation to know in advance what will be covered.
General definition: the exact rules are those of your policy wording.
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