Unlike life insurance, the policy number changes each time a health insurance is renewed. So, over a 25-30-year period, many changes in policy number formats can be expected as health insurers modify their product features, change their TPAs, etc.
On top of this, if you have ported your policy once or twice (often from the frying pan into the fire kind of scenario!), these changes are more complicated to track.
When we apply for pre-authorization of a cashless claim at the time of hospitalization, the first thing the claim process department or TPA will check is the policy history.
A good policy for the insurer is to print the policy history at the back of each policy document, making it easier for the claims dept. to determine if it is an early claim (within the waiting period). Sometimes they do it, and sometimes they don’t.
If your policy does have a 5-6-year history of previous policy numbers, make sure you ask the hospital to send a copy of the document when they contact the insurer of the TPA for the cashless claim. Just the ID card won’t do as it could lead to a lot of back and forth and waste time.
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If your policy does not have the history of previous policy numbers, you must submit it to the hospital and insist it be sent to the insurer. This will take 1-2 hours to compile or not at all, depending on how long you have held the policy.
You or your family will not want to do this after hospitalization or just before. Therefore, the best time to do this is now, each time you renew or port the policy.
You can create a text or spreadsheet document with the following columns
Policy term (from and to dates), Policy Number, Claim made Y/N, Remarks
Keep a printout with the policy document and ID card and insist it is sent to the insurer during a cashless (or reimbursement claim). You could have a much smoother experience.
Your agent can help you send policy history to the TPA (mine did), but it all depends on your relationship with her and whether you have ported or not.
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