Claim Process

Claim Process of Health Insurance 

An insurance claim is when you have a loss or sustain damage that is caused by a peril insured by your insurance policy. Your insurance policy provides coverage and compensation to your for covered losses or the damages you sustain by way of you making a claim.

Depending on the type of insurance claim you are making, the process will be different. Home insurance and personal property insurance claims will involve meeting with adjusters, getting approvals for estimates, making repairs, or replacing items.

There are two ways to make claim under a Health Insurance Policy: on cashless basis and on a reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for reimbursement claim are obtained after hospitalization.

Cashless Service: Seeking Pre-Authorization
           Complete the pre-authorization form available at the hospital's insurance/TPA Desk. Send the completed form via email or fax. Approved letter will be sent by the claim management team. Remember that the claim management team could send an inquiry to the hospital or you before authorization. In case the authorization is rejected, initiate the treatment and file claim for reimbursement.

Reimbursement Claim: Claim Submission
            Complete the necessary form and submit along with required documents, as per the policy terms and conditions. Necessary documents include discharge summary, prescriptions, bills etc. Approved letter will be sent by the claim management team. Remember that you will be answerable to any queries raised by the claim management team before the letter is issued. In case the claim is rejected, the reasons will be communicated by the team. In case of any emergencies, you need to inform the insurance company within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization.

Claim Process of Travel Insurance

The insured should register the claim within 24 hours of claim occurrence either by contacting the insurance company via calling the toll-free number or through email. Customer can also contact us and register a claim on . Claim intimation should be done by filling the claim form properly with correct information with the necessary set of documents. Below mentioned information should be provided while registering a claim with the Insurance Company’s Claim Team:

• Claim Form Duly Filled - Insured’s name, contact details and policy details
• Nature of incident
• Date and time of the incident
• Location of the incident
• Discharge Reports
• Original Bills
• Visa Copy entry and exit stamp
• Cancelled cheque

Note: Above documents are not exhaustive and may require to submit other documents as per the request received from the Insurance Company.

Claim Process of Motor Insurance

The first thing to make a claim is to call on the insurance company’s toll-free helpline number. Submit the required documents to the us. The insurance company will confirm the liability.You have to pay for the repair charges and then submit the bills with a claim form to the us/company for settlement. Then the vehicle is delivered.