Claim Process - Aditya Birla Health Insurance

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

How to intimate health claim with Aditya Birla Health Insurance

Planned Treatment - At least 48 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization
E-Mail
customercare.abh@adityabirla.com
Register Claim Online
Claim Helpline
1800-103-1033
Nearest Branch

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.

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 within 15 days of discharge.

 

The claim file has to be submitted at the below mentioned addresses within 15 days of discharge.
Courier Address
Aditya Birla Health Insurance Co limited 10 th floor, R tech, Nirlon IT park, Western express highway, Goregaon East, Mumbai 400603




List of Documents

List of documents required are

  • Claim form part A(Duly completed by Insured)
  • Claim form part B(Duly completed by Hospital)
  • Health Card or Policy copy
  • KYC documents( Photo ID, Address & age proof)
  • Copy of hospital Registration certificate.
  • Original discharge card/day care summary/transfer summary or death summary.
  • Original final hospital bill with break up along with all the original deposit and final payment receipts.
  • Original invoice with the payment receipt for those charges which are billed outside the main hospital bill.
  • Implant stickers G invoice for all implants used during the surgeries.
  • Letter from the treating medical practitioner stating complaints,duration,past history and treatment details
  • All the previous consultation papers for the current ailment
  • All the original diagnostic reports(including imaging and laboratory)along with prescription and bills.
  • Pharmacy/medical bills along with prescription

In case of accident additional documents required are

  • Meico lagal certificate MLC/FIR copy
  • Letter of the treating from medical parctitioner stating the details of accident/trauma and influence of alcohol/intoxication
  • Pre and post-operative imaging reports

Process of Claim

01
The treatment is to be intimated within prescribed timelines.
02
Post completion of treatment, documents are to be collected from hospital during discharge.
03
The claim file is to be prepared with ref to check list,(The claim form part B is to be filled by hospital)
06
Post receiving of all required info, the claim will be processed within 30 days.
05
Insurer will inform about any deficiency within 7 days.
04
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
07
If the claim is approved, amount will be transferred within 30 days.
08
If the claim is rejected, letter with details are to be shared with Insured.
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