OneAssure: Making Health Insurance Claims Easy: A Customer Testimonial

OneAssure: Making Health Insurance Claims Easy: A Customer Testimonial

At OneAssure, we understand that health insurance can be complex, and navigating claims can be particularly stressful, especially when you're already dealing with health concerns. That's why we're dedicated to simplifying the process and providing exceptional support to our customers. Recently, I had the pleasure of speaking with Mr. Abhinay Sinha, one of our valued customers, about his experience with OneAssure and his successful claim reimbursement. His story highlights our commitment to making health insurance accessible and hassle-free.

"OneAssure has been incredibly supportive," Mr. Sinha shared. "When I met with a minor accident for which I had my knee operated on in October 2024, OneAssure team supported me throughout, right from Claim process to disbursement of claim in my account. I thank them for the support and utmost professional behaviour in their work”.

Mr. Sinha had purchased HDFC ERGO health insurance policy through OneAssure. He emphasized how helpful our team was in explaining the intricacies of the policy, including the often-confusing details about waiting periods.

The Unexpected Health crisis & The Need for a Smooth Claim Process

Guidance and support were provided by the One Assure team during the entire claim process for my HDFC Ergo policy, following my knee operation in October 2024. The team's professionalism and assistance are highly valued.

Mr Sinha reached out to OneAssure, and our support team immediately helped him with the claim documentation. Thanks to his comprehensive policy and proper guidance, he received his reimbursement within a short period, without any hiccups.

"The OneAssure team supported me throughout the entire process, from initiating the claim to receiving the amount in my account. Their professionalism and dedication made a stressful situation much easier. I truly appreciate their assistance and the way they handled everything with such efficiency."

This level of commitment highlights why OneAssure stands out in making health insurance claims seamless and stress-free for customers.

How OneAssure Simplified Health Insurance for Him

One of Mr Sinha’s biggest concerns was the waiting period—a common feature in health insurance policies. Many policies have waiting periods ranging from 30 days to 4 years for certain conditions, which can be a challenge for those needing immediate medical assistance. However, OneAssure helped Rahul choose a policy with a shorter waiting period for pre-existing conditions and covered hospitalization expenses almost immediately for accidental injuries.

Additionally, we guided him through policy terms such as sub-limits, co-payments, and exclusions, ensuring he fully understood his policy before purchasing it. This proved beneficial when he had to make a claim.

Understanding Waiting Periods: A Crucial Aspect of Health Insurance

Waiting periods are a critical component of every health insurance policy. They represent the time you must wait after purchasing the policy before you can claim coverage for specific treatments or pre-existing conditions. These periods vary depending on the policy and the ailment. Understanding these periods is crucial to avoid claim rejections.

• Initial Waiting Period: This is a short waiting period, usually 30 to 90 days, applicable to most treatments. No claims are entertained during this period except for accidental hospitalization.
• Waiting Period for Specific Illnesses/Treatments: Many policies have a waiting period of 1 to 4 years for specific illnesses like cataracts, hernia, joint replacements, etc.
• Waiting Period for Pre-Existing Diseases: If you have a pre-existing condition at the time of purchasing the policy, it will be covered only after a waiting period, typically ranging from 2 to 4 years.

OneAssure partners with a range of reputable insurance providers, each offering different policies with varying waiting periods. We strive to match our customers with the best policy based on their individual health needs and risk profile. Some of the companies we work with that often offer competitive policies include. It's essential to compare policies and understand the waiting periods before making a decision.

Best Health Insurance Providers Recommended by OneAssure

If you’re looking for reliable health insurance plans, here are some of the top companies offering excellent coverage, quick claims, and policies for people with PED:

1. HDFC ERGO Health Insurance

⭐ Claim settlement ratio: 95.30%

⭐ Offers customized plans for PEDs

⭐ Strong network of hospitals for cashless treatment

2. Care Health Insurance

⭐Claim settlement ratio: 90.50%

⭐ Comprehensive PED coverage

⭐ Wide range of family and individual plans

3. Max Bupa (Niva Bupa) Health Insurance

⭐Claim settlement ratio: 85.18%

⭐ Covers pre-existing conditions with a manageable waiting period

⭐ Excellent customer service and claim assistance

         4.  TATA AIG Health Insurance

⭐ Claim settlement ratio: 85.32%

⭐ Strong cashless hospital network

⭐ Quick and seamless claim approval process

        5. ICICI Lombard Health Insurance

⭐Claim settlement ratio: 99.70%

⭐ Covers OPD, daycare, and hospitalization expenses

⭐ Fast cashless claim approval process

Choosing the right insurance provider can be overwhelming, but OneAssure helps you compare policies and find the one that best suits your needs.

The Claim Reimbursement Process

While the exact process may vary slightly between insurance companies, here's a general overview of the health insurance claim reimbursement process:

• Inform the Insurer: Notify your insurance company as soon as you are hospitalized or undergo a treatment. This can usually be done online, via phone, or through email.
• Gather Documents: Collect all the necessary documents, including:

     ✅ Claim form (available from the insurer or OneAssure)

                 ✅ Discharge summary from the hospital

                 ✅ Medical bills and receipts

                 ✅ Diagnostic reports

                 ✅ Prescription copies

                 ✅ ID proof and policy documents

• Submit the Claim: Submit the completed claim form and all supporting documents to the insurance company or through OneAssure.
• Verification: The insurance company will verify the submitted documents and may contact the hospital for further information.
• Claim Approval/Rejection: Based on the verification, the insurance company will approve or reject the claim. If approved, the reimbursement amount will be transferred to your bank account.
• Follow Up: In case of any delays or queries, follow up with the insurance company or OneAssure for updates.

How to Avoid Claim Rejection: Essential Tips from OneAssure

Rahul’s experience highlights the importance of choosing the right policy and understanding the claim process. To ensure a smooth claim settlement, here are some essential tips that every policyholder should follow:

1. Disclose All Pre-Existing Conditions Honestly

• Many claims get rejected because customers do not declare pre-existing diseases while purchasing a policy.
• Insurers conduct medical underwriting, and hiding medical history can lead to claim rejection.

2. Understand Your Policy’s Waiting Period

• Different policies have different waiting periods for pre-existing conditions.
• Some insurers offer plans with reduced waiting periods—always check before purchasing.

3. Ensure Timely and Proper Documentation

• Submit all required documents, including hospital bills, doctor’s prescriptions, and discharge summaries.
• Incorrect or missing paperwork can delay or result in claim rejection.

4. Opt for Network Hospitals for Cashless Claims

• If your insurance provider has tie-ups with hospitals, opt for cashless treatment to avoid out-of-pocket expenses.
• This eliminates the hassle of reimbursement and speeds up the process.

5. Follow the Claim Process Carefully

• Whether you are filing a cashless or reimbursement claim, ensure you adhere to the insurer’s process.
• Notify your insurer as soon as hospitalization occurs to avoid last-minute hassles.

Final Thoughts: OneAssure—Your Trusted Partner in Health Insurance

Mr Sinha’s story is just one of many where OneAssure has helped customers secure the right health insurance policy and navigate the claim process without any hassles. His successful claim reimbursement was the result of making informed choices and understanding his policy in-depth—something that OneAssure ensures for all its customers.

If you are looking for a smooth, transparent, and guided experience in choosing and claiming health insurance, OneAssure is here to assist you. We believe in making health insurance easy, accessible, and hassle-free for everyone.

Have questions about your policy or need assistance with a claim? Contact OneAssure today and let us guide you toward the best health coverage for you and your family.

Mr. Sinha's testimonial is a testament to our commitment to providing exceptional service and simplifying the complexities of health insurance. At OneAssure, we believe that everyone deserves access to quality healthcare and a hassle-free insurance experience. We're here to guide you every step of the way, from choosing the right policy to navigating the claims process. Contact us today to learn more about how we can help you secure your health and your future.