HOW LONG DOES A HEALTH INSURANCE CLAIM TAKE?
HOW LONG DOES A HEALTH INSURANCE CLAIM TAKE?
One of the first questions customers ask after submitting a claim is:
“When will I receive my money?”
The answer depends on the completeness of the claim file and the terms of the insurance contract.
According to the claims handbook, the general process includes the following service timelines:
Within 2 working days
The insurer acknowledges receipt of the claim file.
Within 5 working days
If additional documents are required, the customer may receive a request for supplementation.
Within 9 working days
The claim decision is made after the insurer has received a complete claim file.
Within 3 working days
Payment is made after the claim decision.
This means the handbook describes a total process of approximately 12 working days after the claim file is complete, subject to the applicable circumstances and contract terms.
Example
You submit a claim on Monday.
The insurer receives the documents but identifies that a medical report is missing.
The claim is not yet considered complete.
You provide the missing document.
The assessment period then proceeds based on the complete claim file.
The important distinction
“I submitted my claim” does not necessarily mean “my claim file is complete.”
If additional documents are required, the assessment may need to continue after those documents are received.
Tip
When submitting a claim, don’t focus only on submitting it quickly.
Focus on submitting a complete and consistent claim file.
That can help avoid unnecessary back-and-forth.
