What is the main purpose of the 'claims process' in health insurance?

The main purpose of the claims process in health insurance is to outline the steps for policyholders to file claims and receive reimbursement for covered medical services. This process is essential because it delineates how individuals can seek financial assistance for their medical expenses incurred under their health insurance policies. It involves submitting relevant documentation, such as medical bills and proof of services provided, enabling insurers to assess whether the claims align with the terms of the policy.

Efficient claims processing ensures that policyholders are reimbursed promptly for eligible expenses, which reinforces the insurance system's role in providing financial support during healthcare needs. It serves as a crucial mechanism for the operational functionality of health insurance, ensuring that insured individuals can access the benefits they have paid for through their premiums when necessary.