OneInsure is powered by Robinhood Insurance Broker Limited
Health Insurance

Process of Claim

Claim Process

Edelweiss 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. Submission of Claim File

Intimate claim process

How to intimate health claim with Edelweiss General Insurance

E-Mail
support@hizuno.com
Claim Helpline
180012000
Click Here
Register Claim Online
Click Here
Planned Treatment - At least 72 Hrs prior to hospitalization
Emergency Treatment - Within 48 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:-
  • You are required to furnish the following information while intimating a claim:
  • Policy Number.
  • Name of the Policy holder.
  • Name of the Insured in respect of whom the claim is being made.
  •  Nature of illness or Injury.
  • Name and Address of the attending Medical Practitioner and Hospital.
  • Any other Information, documentation or details requested by the company.
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 & 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 & 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.
List of Documents

  • In-patient Treatment /Day Care Procedures
  • Duly filled and signed Claim Form.
  • Photocopy of ID card / Photocopy of current year policy.
  • Original Detailed Discharge Summary / Day care summary from the hospital. Original consolidated hospital bill with bill no and break up of each Item, duly signed by the insured.
  •  Original payment Receipt of the hospital bill with receipt number
  •  First Consultation letter and subsequent Prescriptions. Original bills, original payment receipts and Reports for investigation supported by the note from Attending Medical Practitioner / Surgeon demanding such test
  • Surgeons certificate stating nature of Operation performed and Surgeons Bills and Receipts
  •  Attending Doctors/ Consultants/ Specialist's/ Anesthetist Bill and receipt and certificate regarding same
  •  Original medicine bills and receipts with corresponding Prescriptions
  •  Original invoice/bills for Implants (viz. Stent /PHS Mesh/ IOL etc.) with original payment receipts
  • Hospital Registration Number and PAN details from the Hospital
  • Doctors registration Number and Qualification from the doctor
  • Road Traffic Accident
  • In addition to the In-patient Treatment documents
  • Copy of the First Information Report from Police Department / Copy of the Medico-Legal Certificate
  • In Non Medico legal cases
  • Treating Doctor’s Certificate giving details of injuries (How, when and where injury sustained)
  • In Accidental Death cases
  • Copy of Post Mortem Report (if conducted) & Death Certificate
  • Pre and Post-hospitalisation expenses
  • Duly filled and signed Claim Form
  • Photocopy of ID card / Photocopy of current year policy 
  • Original Medicine bills, original payment receipt with prescriptions
  • Original Investigations bills, original payment receipt with prescriptions and report
  • Original Consultation bills, original payment receipt with prescription
  • Copy of the Discharge Summary of the main claim
Registered Address
2nd Floor, Tower 3, Wing B, Kohinoor City Mall, Kohinoor City, Kirol Road, Kurla (West) Mumbai City MH 400070

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
Edelweiss 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.
Retirement Plan Offer
+
-
  • Save ₹3,900/month & get
    up to ₹50 Lakhs on Retirement
    or ₹30,000 Pension/month
    CHECK NOW