Question

In the event that the health insurer fails to send claims forms to the insured within the required time period, what should the insured do according to the claims form provision?

Answer 1

If the claims forms are not sent by the insurer in time, the insured should write a notice of claim including details of the loss or injury to the insurance company to start processing the claim.

Step-by-step explanation:

If a health insurer fails to send claims forms to the insured within the required time period, the insured should proceed by submitting the claims themselves, typically by writing a written notice of claim to the insurer. This notice should contain information about the nature and extent of the loss or injury so that the insurance company can start processing the claim even without the standard form. The claims form provision generally allows the insured to submit a proof-of-loss form or other written documentation if the insurer does not provide the necessary forms in time.