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What is an insurer query?

After you file a reimbursement claim, the insurer may raise queries for these three major reasons:

  1. Inadequate information - in case they need more clarity (e.g. first consult paper etc.)
  2. Doubtful information for accident cases - clarification needed on incident from doctors (e.g. FIR, patient narration etc.) to verify the reality of the incident
  3. Missing information - in case the documents you submitted lack a piece of important information

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Confused about queries raised by your insurance company?
Not sure what to do when a query is raised?

A query is nothing but some simple questions on the expenses mentioned in the claim amount asking for more clarity on your paperwork or documents. Consult with an expert to identify what deficiency your claim paperwork may have and prepare for resolution with a plan of action.

I have a query about inadequate information. What do I do?

Once a query is raised by your insurer, there can be a deficiency in your paperwork. Let an expert do a review on your documents to resolve the query.

How do I get the documents mentioned in the query?

A query can be raised for many reasons. If the query concerns information on your medical claim for an accident, there might be a requirement of doctor's narration and FIR. Talk to your insurer/TPA to understand what document they need. Ask an expert for more advice.

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What to do when a query is raised by insurer for
medical history?

If your insurer raises queries for medical history, it is generally for inadequate information. Your insurer may need more documents for clarity, e.g. first consult paper, investigation reports since the treatment started or other supporting documents. Ask an expert to help identify the paperwork deficiency.

What additional documents do I need to resolve the query
on my insurance claim?

If a query is raised for missing documents, your insurer may need supporting documents such as original copy of a document or lab reports for which you may have submitted a bill in your claim. Ask an expert to learn more.

Why does insurer ask for more documents
for accident-related treatments?

After you submit a claim for an accident, clarification of the incident from doctors (to certify that the patient was not under the influence of alcohol) can be needed along with a copy of FIR and patient narration.

As per the query, my name or DOB is not matching with
the given documents for filing claim. What do I do?

Insurer query is not the end of your reimbursement claim. You can talk to your insurer/TPA and
re-submit supporting documents for your medical claim. Ask an expert to know more.