When you or a loved one falls ill, the last thing you want to worry about is the financial burden of hospitalisation and medical treatment. This is where health insurance comes in handy, providing you with financial support during tough times. But to make sure that you get the insurance benefits you are entitled to, it is essential to have the right documentation, and supportive investigation reports play a crucial role in this regard.
What is a supportive investigation report?
In health insurance, supportive investigation reports are critical documents that help insurers process claims related to hospitalisation and medical treatment. These reports contain the findings of the medical tests that a patient has undergone and confirm if they need hospitalisation and active treatment. Positive supportive investigation reports provide evidence that the patient was indeed suffering from an illness that required hospitalisation, making it easier for the insurer to process the claim.
Why are supportive investigation reports necessary?
In group health insurance, whether it’s cashless or reimbursement claim, the policy requires a minimum of 24 hours of hospitalisation with active treatment to be eligible for the benefits. Without a supportive investigation report, the hospitalisation cannot be justified, and the claim will be rejected. The supportive investigation report acts as proof of the ailment and the need for hospitalisation, making it easier for the insurer to process the claim.
Impact of not having a supportive investigation report
If you fail to provide a supportive investigation report, the insurance company or the TPA will not process the claim. The supportive investigation report confirms the hospitalisation of the insured person on the mentioned dates at the hospital. Without it, there is no evidence of hospitalisation or treatment, and the claim cannot be processed.
Examples of supportive investigation reports:
Supportive investigation reports are necessary for various medical conditions. Some examples include:
- Typhoid : Positive results of the medical test that confirm the diagnosis of typhoid fever.
- Fracture : X-ray reports and films that show the fracture to confirm the diagnosis.
- Kidney stones : Ultrasound reports and films to confirm the presence of kidney stones.
- Jaundice : Bilirubin test reports along with other blood test reports such as LFT, CBC, etc., to confirm the diagnosis of Jaundice.
- COVID-19 : RT-PCR test reports to confirm the diagnosis of COVID-19.
Supportive investigation reports are essential documents that help insurers process health insurance claims related to hospitalisation and medical treatment. These reports provide evidence of the ailment and the need for hospitalisation, making it easier for the insurer to process the claim. Without supportive investigation reports, the claim cannot be processed, making it crucial to have them ready during medical emergencies. So, make sure to get your supportive investigation reports from your healthcare provider to ensure that you receive the insurance benefits you are entitled to.