Settlement advice letter for main claim processed by other TPA/Insurer.
Introduction
A settlement letter is an official documentation from the insurer that clarifies your medical expenses and highlights the resolution of your claim; if it’s approved, denied, or partially covered. This makes it an important document to be submitted while applying for a health insurance claim.
Why is it important?
- Resolution of Claim: Settlement Letter is an official statement that confirms if the claim has been reviewed and if it has been approved or denied. If the claim is approved, the letter will carry the amount the insurer has to pay and the copay/coinsurance/deductibles to be borne by the insured.
- Ensures Compliance with Insurance Terms: Settlement letter ensures if the claim was processed in line with the policy’s terms and conditions.
- Prevents Future Disputes: Settlement letter provides a formal explanation of the insurer’s decision. If the policyholder disagrees with it, the letter can help in appealing the decision. If a similar claim is filed in future, the settlement letter can also act as a reference.
How to get this document?
The claim settlement letter will be sent by the insurance company to the policyholder.
Conclusion
The settlement letter is your insurer’s final decision on your claim. Make sure you receive it to proceed with the claim settlement/ further procedures.
