claim/renewals

Health Insurance Claim Procedures

If the illness, injury, or accident is covered by your health insurance policy, you are eligible to file a claim. For planned hospitalization, it is essential to inform the insurance company about the claim 72 hours before admission. It is important to note that the treatment must be taken within 15 days of receiving authorization. In the case of emergency hospitalization, you must inform the insurance company within 48 hours of admission or before discharge, whichever is earlier.

Two options are available for making claims:

cashlesh claim

This option is available when you receive treatment at a network hospital that has a tie-up with your insurance company. The bills are settled directly between the hospital and the insurance company. You need to present your insurance company-issued Health Card/Policy Papers at the Help Desk of the hospital.

Documents for a cashlesh claim

  • Policy health card
  • Identity proof of the insured
  • Doctor’s advice for hospitalisation
  • For a planned hospitalisation, a Pre-Authorisation form would be required
  • Treatment-related documents, previous diagnostics, etc.

reimvursement claim

This option is available when you receive treatment at a non-network hospital or opt for treatment that is not covered under the cashless facility. You can file for reimbursement of expenses by submitting the necessary documents such as bills, medical reports, and other supporting documents.
Remember: While leaving the hospital make sure to ask for Original Copies of all the treatmentrelated documents and the bills and receipts. These documents are crucial when making a reimbursement claim.

Documents Required for Health Insurance Claim Reimbursement
If you make a reimbursement health insurance claim for your medical expenses, you need to submit the following documents:

  • Policy health card
  • Identity proof of the insured
  • Doctor’s advice for hospitalisation
  • For a planned hospitalisation, a Pre-Authorisation form would be required
  • Treatment-related documents, previous diagnostics, etc.