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Health Insurance

Process of Claim

Claim Process

Bharti AXA General Insurance

Instant Help With Emergency Claim

For any emergency claim call us on 8659986599

Steps

Navigating Claims Made Simple: Your Guide to a Hassle-Free Process.

  1. Intimation
  2. Availing Treatment
  3. Compilation /  Submission of Claim File

Intimate claim process

How to intimate health claim with Bharti AXA General Insurance

Planned Treatment - At least 48 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization

Details required for Registration/ Intimation of Claim

To Register claim by calling/FAX on above contact point, you will need to provide the following information to the customer support executive:-
  • Policy number
  • Your Name
  • Your relationship with the Policyholder
  • Nature of Illness or Injury
  • Name and address of the attending Medical Practitioner and the Hospital
  • Any other information that may be relevant to the Illness/Injury/Hospitalisation
Once the claim is registered, the customer support executive will provide you with a Claim Reference/Intimation Number.

Types of Claims

How to intimate health claim with Bajaj Allianz General Insurance

Points to Remember

  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  • The claim is decisioned only when all required & necessary documents are submitted.
  • NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  •  Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  • Unreasonable & Non medical expenses are not payable.
  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  • The claim is decisioned only when all required & necessary documents are submitted.
  • NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  •  Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  • Unreasonable & Non medical expenses are not payable.

 

 The claim file has to be submitted at the below mentioned addresses.

 
 The claim file has to be submitted at the below mentioned addresses.
List of Documents

  • Claim form with duly signed by insured (Part I) and treating doctor (Part II)
  • Original discharge summary
  • Original final bill with receipt & detailed break up towards the final bill (item wise/cost wise)
  •  Original lab reports with advice for investigation undergone from the treating doctor (Doctor Prescription/Consultation)
  • A letter from treating consultant stating past history if any with duration of the said ailment
  • A letter from the treating consultant stating details of accident and initial assessment- alcohol intoxication if any, (if the case of injury or accident) with  MLC COPY / FIR copy in case of RTA/any injury/assault/poisoning etc.
  • 1st consultation paper before the admission, if any
  •  Hospital registration certificate if the hospital is in non-network/remote location
  • A letter from insured stating reason for delay in submission of claim documents. (If delay more than 30 days after the discharge)
  •  Policy copy/Health ID card/ Health TPA ID card with ID proof & Address proof for patient & proposer
  •  Cancelled cheque for Electronic fund transfer in the name of proposer

Process of claim

1
The treatment is to be intimated within prescribed timelines.
2
Post completion of treatment, documents are to be collected from hospital during discharge.
3
The claim file is to be prepared with reference to check list. (The claim form part B is to be filled by hospital)
4
Post receiving of all required info, the claim will be processed within 30 days.
5
Icici Lombard will inform about any deficiency within 7 days.
6
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
7
If the claim is approved, amount will be transferred within 30 days.
8
If the claim is rejected, letter with details are to be shared with Insured.
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