Process of Claim

Claim Process

Aditya Birla Health 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 Aditya Birla Health Insurance

E-Mail
care.healthinsurance@adityabirlacapital.com
Claim Helpline
1800-270-7000
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Register Claim Online
WhatsApp Insurer
8828800035
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Planned Treatment - At least 72 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization

Details required for Registration/ Intimation of Claim

  • Health Card
  • Policy Number
  • Name of Policyholder
  • Name and Address of Insured person in respect of whom claim is made.
  • Nature of illness/injury and treatment/ Surgery required.
  • Name and address of attending Medical practitioner.
  • Hospital where treatment / surgery is proposed to be taken.
  • Proposed date of admission.
  • Date of Discharge
  • Approximate Claim Amount

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
9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai 400013.

Process of claim

1
Please check whether hospital is in network. (https://www.adityabirlacapital.com/healthinsurance/locate-care/hospital-listing)
2
Get in touch with TPA desk within 24 hrs.
3
Filled in Pre authorized form and policy details to be handed over to insurer.
4
During discharge, hospital TPA cell sends final bill with reports to Insurer.
5
If a Query is raised, then it has to be replied and if satisfactory, initial approval is given.
6
Details scrutinized by insurer
7
Insurer approves the final amount.
8
While taking discharge, customer pays the difference of actual bill and approved amount (i.e., non-approved expenses)
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