GPLA status (Number of living children and Gravida details)
For maternity claims, both cashless and reimbursement, insurers ask for the GPLA (Gravida – number of times a woman conceived, Parity (the number of times a woman has given birth), Living Children, Abortion) status of the person. It is typically used to prevent fraudulent claims and decide if the claim is payable as per maternity claim policies.
Why is GPLA Status Important?
GPLA status gives the most basic idea of a woman’s pregnancy history, important to assess any risk in approving the claim and evaluate the person’s applicability for the claim. For instance, if the policy covers only two deliveries, GPLA status gives the number of times the person has given birth.
Usually, health insurance does not cover maternity-related treatments. In certain cases it covers only the first two births, making GPLA status a mandatory document, especially in group health policies. An accurate GPLA status ensures that the necessary benefits and coverage are offered and the maternity claim process is streamlined.
Members must ensure their GLPA status is updated and accurate to facilitate smooth claim processing.
How to Submit?
A typical GPLA certificate would like this:
Where Can You Find This Document?
The treating doctor is required to provide the GPLA status to the insurer once a maternity claim is filed. The GPLA certificate should be on the hospital letterhead/ letterhead of the doctor and need to be submitted in original.
Conclusion
Considering the intricacy of insurance claims, ensuring transparency in every step is a necessity. In case of maternity claims, GPLA status is the way to do it. With this, insurers can stay clear of any possible risks and assure all the criteria are met.
