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The Most Common Health Insurance Claims and How to Avoid Them

Health Insurance Claims


Everyone’s lives depend on quality healthcare, but it can be expensive. People who have health insurance have the financial cover they need to access high-quality medical care. But dealing with the claims process can be difficult, and many people find it stressful. To address these issues, it is critical to be aware of the most common health insurance claims and to adopt preventative actions.

List of Most Common Health Insurance Claims

In order to make informed elections regarding their healthcare coverage, people must understand the typical health claims. It’s crucial to conduct research on the available possibilities to compare prices of various plans in order to get the best health insurance in India.

Hospitalisation Expenses

Hospitalisation costs are among the most frequently filed health insurance premium calculator claims, and they include everything from food and lodging to medical treatments, nursing care, and other services. It’s essential to select a plan that meets your individual healthcare needs, as different policies may have varied limits on hospitalisation expenses.

Outpatient Treatments

The term “outpatient treatments” refers to healthcare services like doctor visits, blood tests, and imaging scans that don’t require hospitalisation. While some health plans  might, others might not, cover outpatient therapies. It’s important to carefully check the specifics of your plan to ascertain what is and isn’t covered.


Prescription drug costs are frequently covered by health plans, while the details of the coverage may differ. While some health insurance plans might include a list of approved prescriptions, others might pay for any medication that a doctor has recommended.

Diagnostic Testing

In order to properly detect and treat medical issues, diagnostic tests including blood test, X-rays, and MRIs are frequently required. The cost of these tests is covered by insurance plans, however again, the details of the coverage may vary.

Emergency Department Visits

It’s important to have an insurance policy that will cover the cost of emergency room visits because they can be very expensive. A previous permission process or a cap on the number of visits may be necessary for emergency room coverage under many insurance plans.

Surgical Procedures

Health insurance plans cover a variety of healthcare services, including surgical operations. The total number of covered surgical procedures may be restricted under some plans, while all required surgeries may be covered under others.

Tips for Preventing Common Health Claims

The following are some strategies to evade the most typical insurance claims:

  1. Stay Healthy – Maintaining good health is one of the best methods to prevent insurance claims. This includes maintaining a healthy diet, exercising frequently, and abstaining from dangerous habits like smoking or binge drinking.
  2. Choose The Best Health Insurance PlanTo choose the best health insurance in India for your needs and finances, read coverage specifics and limitations carefully. Use a health insurance premium calculator to compare plans for affordability. Understand your coverage and any restrictions, including covered procedures, medications, and treatments, to avoid unexpected costs.
  3. Remain in Network – Many insurance plans feature a network of medical professionals who provide services at a reduced cost. By remaining within your provider’s network, you can save money and avert unforeseen costs.
  4. Be Proactive in Managing Your Health – Routine check-ups and preventative care can assist you in avoiding later, more significant health issues. You can lower your likelihood of having expensive medical treatments or hospital stays by maintaining good health.


Having a comprehensive understanding of common insurance claims and taking preventive measures is vital. To optimise healthcare while minimising expenses, it’s crucial to carefully review the plan and identify which diagnostic tests are covered. By being proactive about healthcare and selecting the most suitable health plan, individuals can safeguard both their health and finances.

Niva Bupa is a trusted provider of best health insurance plans that give both individuals and families complete coverage. The company realises how crucial it is to have affordable access to high-quality medical treatment without having to worry about the cost. To meet diverse requirements and budgets, Niva Bupa provides one of the best mediclaim policy for familywith different levels of coverage.

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