US Medical Term · insurance
Insurance Claim
Reclamación de Seguro
In 9 languages
| Language | Term |
|---|---|
| English | Insurance Claim |
| Spanish (Español) | Reclamación de Seguro |
| Chinese (中文) | 保险理赔 |
| Korean (한국어) | 보험 청구 |
| Vietnamese (Tiếng Việt) | Yêu cầu bồi thường bảo hiểm |
| Filipino (Tagalog) | Insurance Claim |
| Portuguese (Português) | Sinistro de Seguro |
| Thai (ภาษาไทย) | การเรียกร้องสิทธิ์ประกัน |
| Japanese (日本語) | 保険請求 |
What it means
An insurance claim is a formal request submitted to an insurer for payment of a covered health service. For in-network care, the provider typically submits the claim directly on behalf of the patient. For out-of-network care, the patient may need to submit the claim themselves with supporting documentation. Claims are reviewed for eligibility, coverage, and medical necessity. If a claim is denied, patients have the right to appeal — first through the insurer's internal process, then through external review by an independent organization.
Related terms
Related guide
→ US Guide: reading an eob and a medical billSources
Last reviewed: September 2026