Process of Claim

Claim Process

Care Health Insurance Limited

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. Compilation/ Submission of claim file 

Intimate claim process

How to intimate travel claim with Care Health Insurance Limited

E-Mail
travelassistance@careinsurance.com / customerfirst@careinsurance.com
Claim Helpline
1800-102-4499
Register Claim Online
Intimation should be done immediately to company assistance provider

Details required for Registration/ Intimation of Claim

To register a claim/seek assistance through the above contact points, the following information has to be provided to the customer support executive:-
  • Policy Number; 
  • Name of the Policyholder; 
  • Name of the Insured Person in respect of whom the Claim is made; 
  • Nature of the event; 
  • Name and address of the attending Medical Practitioner and Hospital, if applicable; 
  • Date of admission to Hospital or date of loss, as applicable; 
  • Any other information, documents or details requested by the Company or the Assistant Service Provider

Types of Claims

How to intimate health claim with Bajaj Allianz General Insurance

Points to Remember

  • Assistance service provider is to be intimated in the event of any treatment, non intimation may invalidate the claim. 
  • Cashless will be extended for all in-patient treatments only when service provider is intimated & pre approval obtained (as per policy T & C)
  • OPD Claims  & claims other then In-Patient will be reimbursed upon return to India.
  • Policy does not cover traveling abroad for obtaining medical treatment & travelling against medical advice.
  • Assistance service provider is to be intimated in the event of any treatment, non intimation may invalidate the claim. 
  • Cashless will be extended for all in-patient treatments only when service provider is intimated & pre approval obtained (as per policy T & C)
  • OPD Claims  & claims other then In-Patient will be reimbursed upon return to India.
  • Policy does not cover traveling abroad for obtaining medical treatment & travelling against medical advice.

The claim file has to be submitted at the below Mentioned addresses within 30 days after the occurrence of event.

The claim file has to be submitted at the below Mentioned addresses within 30 days after the occurrence of event.
List of Documents

Standard Documents

  • Duly completed and signed Claim form, in original

  • Passport copy with entry and exit stamp

  • Any other document as required by the Company or Assistance Service Provider

  • Additional documents as specified under each Benefit 

Hospitalization Expenses

  • It is a Condition Precedent to the Company's liability under this Benefit that the following information and documents shall be submitted to the Company or the Assistance Service Provider immediately and in any event within 30 days of the event giving rise to the Claim under this Benefit : 

  • Duly filled and signed Claim form 

  • Duly filled and signed 'Release of Medical Information Form' 

  • Original pathological and diagnostic reports, discharge summary, indoor case papersand prescriptions issued by the treating Medical Practitioner or Network Provider. 

  • Copy of Passport with entry and exit stamp of the country of treatment. 

  • Original bills and receipts for: 

  • Charges paid towards Hospital accommodation, nursing facilities and other medical services rendered. 

  • Fees paid to the Medical Practitioner and for special nursing charges. 

  • Charges incurred towards any and all test and/or examinations rendered in connection with the treatment from a registered pharmacy other than the Network Provider duly supported by the prescriptions of the Medical Practitioner attending to the Insured Person.

  • Any other document as required by the Company to assess the Claim. 

  • Only in the event that original bills, receipts, prescriptions, reports or other documents have already been given to any other insurance company or to a reimbursement provider the Company will accept properly verified photocopies of such documents attested by such other insurance company/reimbursement provider along with an original certificate of the extent of payment received from such insurance company/reimbursement provider. 

  • The Company will only accept bills/invoices which are made in the Insured Person's name. 

  • The Company shall condone delay on merit for delayed Claims where delay is proved to be for reasons beyond the control of the Policyholder or the Insured Person. 

Compassionate Visit

  • A certificate from the Medical Practitioner recommending the presence in the form of special assistance to be rendered by an additional member during the entire period of Hospitalization. The certificate shall also specify the minimum period of Hospitalization. 

  • Discharge summary of the Hospital furnishing details including the date of admission and date of discharge. 

  • Original ticket with invoice used for the travel by the Immediate Family Member. 

  • Copy of passport of Immediate Family Member with entry and exit stamp.

Return of Minor Child

  • A certificate from the Medical Practitioner specifying the minimum period of Hospitalization. 

  • Discharge summary of the Hospital furnishing details including the date of admission and date of discharge. 

  • Original ticket used for the return travel of the children to the Country of Residence. 

  • Copy of passport of the children with entry and exit stamp. 

Up-gradation to Business Class

  • A certificate from the Medical Practitioner specifying the minimum period of Hospitalization. 

  • Discharge summary of the Hospital furnishing details including the date of admission and date of discharge. 

  • Copy of the economy class air ticket issued by the Common Carrier indicating the cost the ticket and receipt for the refund of the fare of the Common Carrier and the cancellation charges retained.

  • Boarding pass and copy of business class ticket confirming the return journey and the cost of ticket

Dental Treatment

  • Original pathological or diagnostic reports and medical prescriptions issued by the treating Medical Practitioner or Hospital;

  • Original Bills and receipts for:

  • Fees paid to the Medical Practitioner and special nursing charges; and

  • Charges incurred towards any and all test and/or examinations rendered in connection with the treatment.

  • Charges incurred towards medicines or drugs purchased from a registered pharmacy other than the Hospital duly supported by the prescriptions of the Medical Practitioner attending to the Insured Person; Any other information or documents related to the treatment taken.

Personal Accident

  • Medical reports giving the details of the Accident, nature of the Injury, the extent of disability (if applicable) and the details of treatment provided.

  • Death certificate (if applicable)

  • Postmortem report, if conducted

  • Police report.

  • Medical Practitioner's certificate in case of Injury stating the reasons for and the extent of the Injury.

Common Carrier Accidental Death

  • Medical reports giving the details of the Accident and nature of Injury.

  • Death certificate.

  • Postmortem report, if conducted.

  • Police report.

  • Valid ticket or certificate from the Common Carrier establishing the Insured Person's bonafide travel in the affected Common Carrier at the time of the Accident.

Medical Evacuation

  • Medical reports and transportation details issued by the evacuation agency, prescriptions and medical report by the attending Medical Practitioner furnishing the name of the Insured Person and details of treatment rendered along with the statement confirming the necessity of evacuation;

  • Documentary proof for all expenses incurred towards the Medical Evacuation.

Repatriation of Mortal Remains

  • Copy of the death certificate providing details of the place, date, time, and the circumstances and cause of death;

  • Copy of the postmortem certificate, if conducted;

  • Documentary proof for expenses incurred towards disposal of the mortal remains;

  • In case of transportation of the body of the deceased to the Country of Residence or Place of Residence, the receipt for expenses incurred towards preparation and packing of the mortal remains of the deceased and also for the transportation of the mortal remains of the deceased.

Trip Cancellation and Interruption

  • Confirmation in writing of cancellation of the journey from the Common Carrier detailing the circumstances of cancellation;

  • Ticket/boarding pass issued by the Common Carrier indicating the cost of ticket and receipt for the refund of the fare of the

  • Common Carrier towards the cancelled portion of the journey indicating cancellation charges retained by the Common Carrier.

  • Boarding pass in original for return journey from the place of cancellation to the Country of Residence which indicates the cost of the tickets together with the receipts for the refunds obtained towards the unfulfilled portion of the journey.

  • A declaration from the Insured Person furnishing the circumstances that compelled him to cancel the journey

  • Medical evidence as may be required in case of the cancellation of the journey arising out of personal contingencies of the Insured Person or his Immediate Family Member;

  • Receipt for the refund of the fare of the Common Carrier towards the cancelled portion of the journey indicating the cancellation charges retained;

Loss of Checked –In Baggage

  • Property irregularity report issued by the appropriate authority.

  • Voucher of the Common Carrier for the compensation paid for the non-delivery/short delivery of the Checked-In Baggage.

  • Copies of correspondence exchanged, if any, with the Common Carrier in connection with the non-delivery/short delivery of the Checked-In Baggage.

Delay of Checked-In Baggage

  • Property irregularity report issued by the appropriate authority stating the scheduled time of delivery and actual time of delivery of the Checked-In Baggage.

  • Voucher of the Common Carrier for the compensation paid for the delay in delivery of the Checked-In Baggage.

  • Copies of correspondence exchanged, if any, with the Common Carrier in connection with the delay in delivery of the Checked-In Baggage.

Loss of Passport

  • Copy of the police report

  • Details of the attempts made to trace the passport

  • Original receipt for payment of charges to the authorities for obtaining a new or duplicate passport.

Personal Liability

  • Statement of Claim furnishing particulars of the event leading to the liability such as the court order; Photocopy of the police report (wherever reported). 

Registered Address
Care Health Insurance Limited(formerly known as Religare Health Insurance Company Limited),Unit No. 604 - 607, 6th Floor, Tower C, Unitech Cyber Park,Sector-39, Gurugram-122001 (Haryana).

Process of claim

1
The treatment is to be intimated with respective service providers within prescribed timelines.
2
All prescriptions, investigation reports & medicine bills are to be kept handy.
3
The claim file is to be prepared with ref to check list & to be submitted upon return to India.
4
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
5
Insurer will inform about any deficiency within 7 days.
6
Post receiving of all required info, the claim will be processed within 30 days.
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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