What is the definition of a "claim" in health insurance?

In health insurance, a "claim" refers specifically to a request for payment from the insurer for a covered health care service. When an insured person receives medical care, the health care provider typically submits a claim to the insurance company to seek reimbursement for the services provided. This process ensures that the covered expenses are paid according to the terms of the insurance policy.

This definition encompasses the essence of how health insurance functions—claim submissions are integral to the operation of the insurance system, allowing insured individuals to receive necessary health services without bearing the full financial burden upfront. The claim process is foundational in establishing the responsibilities of the insurer based on the coverage outlined in the policy.

The other options provide explanations of related concepts but do not accurately define a claim. For instance, requesting preapproval of medical treatments refers to prior authorization processes, not to a claim itself. A statement of insurance benefits relates to what the insured is entitled to under their policy but does not constitute a request for payment. Lastly, a notification of policy cancellation does not pertain to claims at all, as it deals with the status of the insurance contract rather than a financial transaction related to care.