Claim-Ready: How To Ensure Your Health Insurance Works In A Crisis

Noida-based Manoj Mittal discovered his father’s cancer a few months ago. Within three days, the family had consulted three oncologists, finalized a treatment plan, and scheduled surgery.

Emotionally and logistically, everyone rallied—except his mother. She spent those frantic days searching for something else entirely: a health insurance policy document from 2017. She remembered it existed, somewhere in a folder, in a drawer, maybe in an old email account she no longer checked.

The family had Rs 10 lakh health insurance coverage. But without the policy number, insurer’s contact details, or the exact terms, filing for a cashless claim was impossible. They ended up paying Rs 4.5 lakh upfront from savings meant for their sister’s wedding.

“We had protection,” Mittal says. “We just couldn’t access it when we needed it most.”

The Documentation Gap

Here’s the uncomfortable truth: India has hundreds of millions of insurance policies in force. Yet when a crisis hits, many families can’t answer basic questions: Which company? What coverage? Where are the papers? Who do we call?

According to the Insurance Regulatory and Development Authority of India (IRDAI) Annual Report 2023-24, around 11 per cent of health-insurance claims were rejected and 6 per cent remained pending as of March 2024. A LocalCircles survey (2023) found that nearly half of policyholders faced partial or full claim rejections in the last three years, often due to incomplete documentation or missing records.

“Most families discover their coverage gaps during claims, not before,” says Venkatesh Naidu, CEO, Bajaj Capital Insurance Broking Ltd.  “Real financial maturity isn’t just buying protection, it’s organising it. The best policy in the world is useless if you can’t access it in your hour of need.”

What Claim-Ready Actually Means

Being claim-ready isn’t complicated. It’s disciplined. It’s about setting up systems that function under stress when your focus should be on people, not paperwork.

Digital Documentation: Scan every policy document and store securely in the cloud. Create a shared family folder of health, life, motor, travel accessible to at least two members. Update it annually. Email copies to yourself, your spouse, and one trusted person outside the household.

The Emergency File: Have one clearly labelled folder at home that everyone can find. Keep your policy numbers, insurer contacts, claim helpline, hospital network list, TPA details, and your advisor’s number inside. In an emergency, you shouldn’t be searching, you should be ready to act.

Regular Policy Audits: Twice a year, take a few minutes to review your policies expiry dates, nominee details, and coverage limits. Life changes quietly, parents age, costs rise, families grow and your protection should keep up.

Maintain Medical Records: Keep all prescriptions, reports, and discharge summaries in one place, physical or digital. Many claims get delayed not for lack of coverage, but because families can’t find the medical papers that tell their story.

Know Your Coverage: Understand inclusions, exclusions, co-pays, and waiting periods. Don’t let fine print surprise you during a crisis.

Cashless Network Familiarity: Know which hospitals in your city are on your insurer’s cashless list. In emergencies, that difference can save both time and emotional bandwidth.

The Ripple Effect

Claim-readiness changes more than your finances; it changes your confidence. When you know exactly where your documents are and how to activate your protection, you approach emergencies differently. You respond instead of react.

A Mumbai-based HR manager keeps a simple Excel sheet updated quarterly, listing every family policy, nominee, renewal date, and claim contact. “It takes me twenty minutes, four times a year,” she says. “Last year, when my husband had an accident, those twenty minutes saved us weeks of chaos.”

“Everyone should think of insurance like a fire extinguisher,” adds Naidu. “You don’t want to read the instructions when your kitchen is burning. Claim-readiness is that quiet preparation that makes families truly resilient.”

The Invisible Maturity

Financial maturity doesn’t show up in bank balances or mutual fund statements. It reveals itself in moments of crisis—when families can focus on healing because the money part works seamlessly. When emergencies don’t spiral into financial disasters because someone planned ahead.

Mittal’s family now keeps a cloud folder with every policy document, medical record, and contact. They update it together once a year. It’s become a boring ritual—mundane, unglamorous.

“It’s the most important thing no one will ever see us do,” he says.

Because protection isn’t just what you buy. It’s what you’re ready to use.