HEALTH CLAIMS
Cashless Network Hospital List:
- ADITYA BIRLA HEALTH INSURANCE CO. LTD.
- ACKO GENERAL INSURANCE LTD
- BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD
- BHARTI AXA GENERAL INSURANCE CO. LTD.
- CHOLAMANDALAM MS GENERAL INSURANCE CO. LTD.
- CARE HEALTH INSURANCE LTD. (Religare Health)
- CAREHEALTH INSURANCE CO. LTD
- EDELWEISS GENERAL INSURANCE CO. LTD.
- FUTURE GENERALI INDIA INSURANCE CO. LTD.
- GO DIGIT GENERAL INSURANCE LTD
- HDFC ERGO HEALTH INSURANCE LIMITED
- HDFC ERGO GENERAL INSURANCE CO.LTD.
- IFFCO TOKIO GENERAL INSURANCE LTD
- ICICI LOMBARD GENERAL INSURANCE LTD
- KOTAK MAHINDRA GENERAL INSURANCE CO. LTD.
- LIBERTY GENERAL INSURANCE LTD
- MAGMA HDI GENERAL INSURANCE CO. LTD.
- MAX BUPA HEALTH INSURANCE CO. LTD
- MANIPAL CIGNA HEALTH INSURANCE COMPANY LIMITED
- NIVA BUPA HEALTH INSURANCE CO. LTD
- NAVI GENERAL INSURANCE LTD.
- NATIONAL INSURANCE CO. LTD.
- ROYAL SUNDARAM GENERAL INSURANCE CO. LTD.
- RELIGARE HEALTH GENERAL INSURANCE LTD
- RELIANCE GENERAL INSURANCE CO.LTD
- SBI GENERAL INSURANCE LTD
- STAR HEALTH & ALLIED INSURANCE CO.LTD.
- TATA AIG GENERAL INSURANCE CO. LTD.
- THE NEW INDIA ASSURANCE CO. LTD
- THE ORIENTAL INSURANCE CO. LTD.
- UNIVERSAL SOMPO GENERAL INSURANCE CO. LTD.
- UNITED INDIA INSURANCE CO. LTD.
It has been observed that, many of the Health Insurance claims are repudiated due to deficiency in required claim documents. Insured/ Customer should have due diligence for below mentioned documents for valid health insurance claim:
The documents are to be submitted to insurance desktop of a network hospital for cashless claim or Insurance Company or TPA for reimbursement claim.
- Inform / intimate insurance company or TPA or us as soon as insured is hospitalized or decides to go for it.
- Minimum 24 hours hospitalization is necessary for all the treatments except the treatments included in the list of Day care or Domiciliary treatments.
- Please check on website of TPA or insurance company that the concerned hospital is blacklisted or not.
- Concerned hospital must be registered as Hospital by local authority.
- Concerned hospital must have minimum 10 beds for small towns & 15 beds for large cities.
- Submit duly filled claim form with medical section filled up by treating doctor.
- Provide clear copy of insurance policies of last 4 years.
- Provide clear copy of Government ID like Aadhar card or Pan Card etc. containing clear birth date of the claimant.
- Provide first consultation paper, pre hospitalization consultations, discharge summary with medical history, receipt of Operation & Operation theatre charges, receipt of Anaesthetist, fees of Surgeon, visiting charges, IPD treatment papers, advice for Investigation reports, medical reports, prescriptions & bills of all medicines (even for repeated) in synchronization with quantities in bills of medicines.
- All the above mentioned documents must be endorsed by treating doctor with seal.
- Original Cheque of bank account of Insured or main proposer is to be provided in case of reimbursement claim.
- Retain a copy of claim fie for whole life.
- Same procedure is applicable for a post hospitalization claim to be logged within stipulated number of days like 60 or 90 days after discharge from hospital. The number of such days varies from company to company.