All health insurance policies are highly promoted by the insurance agencies in order to get a good response towards it. People who do take them either do so keeping all the conditions in mind and after due evaluation or because they are ill informed and put into an illusion that they have made the right choice. In either case, the real test for the validity of these policies comes when the time for a claim arises. Those companies which do not want to pay the claim would keep you beating around the bush further deteriorating your health. This makes it necessary that a health insurance policy should only be taken from a company that has a good reputation and has been known to deliver in the past.

When a medical situation arises and a claim has to be filed, a claim form has to be filled with the insurance agency. This form can be taken from their office or downloaded from their website on the internet. After filling this form and attaching all the relevant documents along with it, it has to be submitted. Some of the attached documents include a doctor's letter describing the condition, diagnosis reports and the bills for the various treatments undertaken. Certain rules govern whether a claim can be filed. One of them involves being admitted for at least a day; else it is considered a regular check up.

Depending upon the health insurance policy taken up (limited coverage or full coverage), the agency is supposed to either surrender a portion of the total bill, wherein, the rest of the bill would have to be borne by the patient or the complete amount. Another kind is the cashless policy where the bills are settled automatically between the hospital and the agency with no involvement from the patient's side. For such a case to come up, the agencies have to have a tie up with the hospital where the treatment is being undertaken.

Disputes can be avoided if all the attached documents are in place and premiums have been paid on time. The insurance company is bound to pay the amount in order to keep its commitment and reputation intact. If a claim is rejected, according to the rules put in place by the governing bodies, they have to give appropriate reasons for the rejection. Generally, the case can be sorted out by taking to the authorities and providing the right documents. Legal action can be taken if no heed is paid to it.

Contact the higher end managers and authority at the insurance firm by either sending a detailed letter or catching them on phone. Explain the situation sighting your policy number and the total steps that have been taken till now. Hopefully, they would be able to suggest a way around the hurdle. If no progress is made on this front, the next step is to contact the regulating body for all the insurance agencies. Keep the legal course as the last measure and follow all the procedures in the proper manner, you are bound to either get the claim or a satisfactory answer for rejection of claim.