Filing Claims

Florida law standardizes the claim forms used for health insurance. Many doctors and hospitals keep claim forms on hand and will file them for you. The following guidelines can help speed up the claims process.

• Inform your insurance company about a claim in writing within 20 days of the accident or illness. You must file your claim within 90 days.
• Contact your agent if you need help filing your claim. You should fill out all claim forms accurately and completely; attach copies of bills when requested, and keep your originals. Have your doctor and hospital representative complete (and sign, if necessary) their sections of the form right away.
• Keep copies of everything you send the company or the company sends to you, including a record of the date you filed the claim.

Please note: Your company should pay a claim promptly after it receives a completed claim form. The company should also provide an explanation for a partial payment or a rejected claim.

For more information, contact your insurance company or HMO representative, or your employer’s human resources office. You should also seek competent medical advice from your doctor and other health care professionals.