Health Insurance

Process of Claim

Claim Process

Oriental 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. Submission of Claim File

Intimate claim process

How to intimate health claim with Oriental Insurance

E-Mail
csd@orientalinsurance.co.in
Claim Helpline
1800118485 Or 011- 33208485
Register Claim Online
Click Here
WhatsApp Insurer
9560711200
Click Here
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 on above contact point, you will need to provide the following information to the customer support executive:-
  • Policy Number
  • ID card no
  • Name of insured person
  • Nature of disease / illness / injury and Name and Address of the attending medical practitioner / Hospital/Nursing Home etc
  • Approximate Claim Amount
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

  •  Cashless is available only in network hospitals of Insurer.
  • Dully filled pre-authorization form is to be submitted along with copy of cards/policy.
  •  Insurer approves part of expected expenses known as Initial approval.
  •  During discharge, on submission of final bill, Insurer approves final amount.
  • Care should be taken to reply to any query, if raised during the process. Unreasonable & Non medical expenses are not payable.
  •  Cashless is available only in network hospitals of Insurer.
  • Dully filled pre-authorization form is to be submitted along with copy of cards/policy.
  •  Insurer approves part of expected expenses known as Initial approval.
  •  During discharge, on submission of final bill, Insurer approves final amount.
  • Care should be taken to reply to any query, if raised during the process. Unreasonable & Non medical expenses are not payable.
List of Documents

  • Copy of id card/Policy copy
  • Duly filled pre-auth form
  • KYC of insured
  • 1st consultation letter/Investigation reports (If Any)
Registered Address
No 7, 4th Floor, Oriental House, J Tata Road Churchgate Mumbai, Maharashtra - 400020 India

Process of claim

1
Find out whether hospital is in network (https://orientalinsurance.org.in/en/network-hospitals)
2
Get in touch with TPA cell
3
Filled in Pre authorized form and policy details to be handed over to TPA cell
4
If a Query is raised, then it has to be replied and if satisfactory, initial approval is given
5
Details scrutinized by insurer
6
Details sent by TPA cell to Insurer.
7
During discharge, hospital TPA cell sends final bill with reports to Insurer
8
Insurer approves the final amount
9
Customer pays the difference of actual bill and approved amount(which are non approved expenses and take discharge
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