Submit your Claim

In a pre -planned hospitalization, the policyholder intimate insurers about the on-coming claim. In emergency hospitalization, claim intimation must be sent to the insurance company or TPA within 24 hours. If you choose a cashless claim, you need to remember your treatment should be at the network hospitals of your insurance company. If it is a pre-planned hospitalization, contact us and let us know your hospitalization details so that we can inform your presence at the hospital to your insurer on your behalf. You are expected to fill a cashless claim request form and submit it to the insurance company via email, as intimated in your policy document.

Submit your Documents

The most important documents are 1. KYC 2. Claim Form 3. Doctor’s prescription If you’ve submitted no documents or partial documents, you’ll have to submit the required documents to process your claim ahead. Additional documents has to be provided by the insured during the process if in case called by the insurer

Insurer Approval

On submission of all the required documents you have submitted an approval from the insurer has to sought.

Hospitalization

The ID card provided by the insurer has to be provided at the time of hospitalization.

Final Approval

If the insurer is satisfied with the documents submitted by the customer, a final approval will be given by the insurer to proceed ahead with the claim

Settlement

Once the formalities are completed the insurance company will settle the bills with the hospital according to the terms and conditions

Rejected

If the all documents provided by the customer are not found to be satisfactory, there is chance that the claim can be rejected. Following are the list of instances where a claim can be rejected. 1) Customer tries to claim during waiting period, or for an ailment which is not included in the policy (example, Cosmetic surgery, OPD claims, or in case there is a permanent exclusion). 2. Customer is making a fraudulent claim.

Intimate your Claim

In a planned hospitalization, a policyholder intimates insurers about the upcoming claim. In emergency hospitalization, claim intimation must be sent to the insurance company or TPA within 24 hours. The reimbursement claim for health insurance can be made if the policyholder chooses to opt any hospital apart from the networked hospitals of the insurance company. In reimbursement claim process the policyholder has to pay for the bills at the hospital. You will have to fill a reimbursement claim request form and submit it to the insurance company via email, post or fax.

Submit your Documents

Some of the important documents are

1. KYC
2. Claim Form
3. Doctor Prescription

If you've submitted no documents or partial documents, you'll have to submit the required documents to process your claim. Additional documents needs to be provided by the insured during the process if in case required/asked by the insurer

Insurer Approval

An approval will be provided by the insurance company for the documents you've submitted.

Hospitalisation

At the time of hospitalization you will have to show the ID card of the insured, which was issued by the insurance company, for the purpose of proving your identification.

Settlement

Once the formalities are completed the insurance company will settle the bills according to the terms and conditions. Any expenses which are not covered in the policy will not be reimbursed.

Rejected

If the all documents provided by the customer are not found to be satisfactory, there is chance that the claim can be rejected. Following are the list of instances where a claim can be rejected.

1. Customer tries to claim during waiting period, or for an ailment which is not included in the policy (example, Cosmetic surgery, OPD claims, or in case there is a permanent exclusion).
2. Customer is making a fraudulent claim.