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How to File a Hospital Indemnity Claim: Step-by-Step Process and Payment Timeline

Reviewed by Russell Noga, Licensed Insurance Agent — Last updated October 31, 2026

To file a hospital indemnity claim, get the claim form or start an online claim, attach hospital records showing your admission and discharge dates and diagnosis, and submit through the insurer’s portal, email, fax or mail. Online filing with direct deposit is usually the fastest way to get paid.

Hospital indemnity claims are simpler than health insurance claims. The insurer is not paying a bill. It is confirming that a covered event happened and paying a fixed amount. That means the paperwork is mostly about proof: who was in the hospital, when, why and in what kind of room. To understand the product itself, see how hospital indemnity insurance works.

This guide covers the full claim and payout process, from the documents you need to how long payment takes. It draws on published claim instructions from MetLife and Aflac. Steps vary by insurer, so always check your certificate or policy.

✔ Online is fastest
✔ Proof, not bills
✔ Paid to you

Key Takeaways

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You need records that show the patient’s name, admission and discharge dates, diagnosis and room type (ICU or not).

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Online portals are the preferred route at MetLife and Aflac.

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MetLife says a complete claim generally takes about 10 business days, with payment 7 to 10 business days after approval.

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Direct deposit is faster than a paper check.

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Most delays come from missing documents. Send everything the first time.

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Documents You Need Before You File

Gather these before you start. MetLife’s group claim instructions list the first four as required for hospital claims.

Required or strongly recommended

✔

Patient name on the hospital records.

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Admission and discharge dates.

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Verified diagnosis.

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Room assignment, showing ICU and non-ICU days.

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Itemized invoice and admission documents.

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ER discharge papers if you came through the emergency room.

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Any Explanation of Benefits from your health plan.

Aflac’s instructions add that claims need diagnosis and procedure codes, the date of service and the doctor or facility name and address. Ask the hospital’s medical records or billing office for a discharge summary. It usually has all of this on one or two pages.

How to File a Hospital Indemnity Claim: 7 Steps

The claim process

1

Notify the insurer: Start the claim as soon as you can after the stay. Check your policy for the notice deadline.

2

Find your policy number: It is on your policy, certificate or ID card. Aflac says you can also get it by phone or from your insurance agent.

3

Get the form or log in: MetLife: mybenefits.metlife.com. Aflac: log in at Aflac.com and start a SmartClaim.

4

Fill in the claim: Pick the patient, the type of claim and answer the questions about the stay.

5

Attach records: Upload or send the hospital documents listed above.

6

Add direct deposit: Both MetLife and Aflac offer it. Aflac does not offer direct deposit on fax or mail claims.

7

Track the claim: Watch the portal for requests for more information and the payment notice.

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Ways to Submit and How Fast Each One Is

Method Who offers it Notes
Online portal MetLife MyBenefits; Aflac SmartClaim MetLife calls it the preferred method. Aflac’s One Day Pay needs an online claim.
Mobile app MetLife Mobile App (per PCSB claim guide) Upload photos of documents.
Email MetLife (address on its claim guide) Put your claim or certificate number on every page.
Fax or mail Most insurers Slowest. Aflac does not offer direct deposit on these.
Phone MetLife 1-866-626-3705 To request forms or ask about status, not to file proof.

Aflac launched One Day Pay in 2015. Under that program, eligible individual hospital indemnity claims submitted through SmartClaim by 3 p.m. ET on a weekday, with all documents, could be processed and paid within one business day. Terms may have changed since.

What Happens After You File: The Payout Process

Here is the payment process in order, based on MetLife’s published group claim guide.

Stage What happens Typical timing
Acknowledgement Insurer confirms it received the claim Letter after successful submission
Review A claims specialist checks the stay against your policy and may ask for more records About 10 business days for a clean claim
Decision Approved, partly approved or denied, with an explanation After review
Payment Check or direct deposit 7 to 10 business days after approval
Explanation of Benefits Shows what was paid and why With the check or online

If you have a second claim from the same stay, MetLife says you do not need a new form. Send the new documents with your claim or certificate number on every page. To estimate the amount you will get, see how much hospital indemnity insurance pays.

Why Claims Get Delayed or Denied

Common reasons

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Missing admission or discharge dates, or no diagnosis on the records.

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Observation stay filed as an inpatient admission. Many plans pay these differently.

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The stay falls in a waiting period, such as a pregnancy wait of 9 or 10 months on some group plans.

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A pre-existing condition limitation applies.

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The event is excluded, such as elective surgery or an ER visit with no admission.

Pre-existing condition denials do happen. Scripps News reported in January 2025 that MetLife denied a June 2024 birth claim under a pre-existing condition limitation, because the pregnancy began before coverage started in November 2023. Read hospital indemnity and pre-existing conditions before you count on a payout.

If a claim is denied: Read the denial letter for the policy section cited. Send any missing records. Ask for the appeal steps in writing. If you still disagree, you can contact your state Department of Insurance.

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Tips to Get Paid Faster

Do

✔ File online and set up direct deposit.

✔ Request a discharge summary before you leave the hospital.

✔ Put your claim or certificate number on every page.

✔ Check the portal for messages every few days.

Avoid

! Sending bills without dates or diagnosis.

! Waiting months to file.

! Filing observation time as an admission.

! Assuming every benefit pays. Read your certificate first.

Talk It Through With a Licensed Insurance Agent

Free help comparing hospital indemnity plans in your state. No obligation.

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Taxes and What to Do With the Money

The payment is yours to use as you choose: deductibles, copays, rent, childcare or travel to the hospital. Whether it is taxable can depend on who paid the premium and how. See is hospital indemnity insurance taxable.

If you do not have a policy yet, compare options on hospital indemnity insurance plans or learn about specific insurers like Aflac hospital indemnity.

The Bottom Line

Filing a hospital indemnity claim comes down to proof. Get records showing the dates, diagnosis and room type, file online, and set up direct deposit. A complete claim is the fastest claim.

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Frequently Asked Questions

➤ How do I file a hospital indemnity claim?

Start a claim online or get a claim form from your insurer. Attach hospital records showing the patient’s name, admission and discharge dates, diagnosis and room type, then submit online, by email, fax or mail.

➤ What documents do I need for a hospital indemnity claim?

Hospital records with the patient name, admission and discharge dates, diagnosis and ICU or non-ICU room assignment. Itemized bills, ER discharge papers and an Explanation of Benefits help.

➤ How long does a hospital indemnity claim take to pay?

It varies by insurer. MetLife says a clean claim generally takes about 10 business days to process, with payment 7 to 10 business days after approval.

➤ Can I file a hospital indemnity claim online?

Yes, with most large insurers. MetLife uses its MyBenefits portal and mobile app, and Aflac uses SmartClaim on Aflac.com.

➤ Do I need a new claim form for more days from the same stay?

At MetLife, no. Send the added documents with your claim or certificate number on every page. Other insurers may differ.

➤ Is there a deadline to file?

Most policies set a notice and proof-of-loss deadline. The claim guides we reviewed did not list one, so check your certificate or policy.

➤ Who gets the money from a hospital indemnity claim?

You do, unless you assign benefits to someone else. The payment is not sent to the hospital.

➤ Why was my hospital indemnity claim denied?

Common reasons are missing records, an excluded event, a waiting period or a pre-existing condition limitation. The denial letter should cite the policy section, and you can appeal.

Have Questions?

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1-888-891-0229

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