Health Insurance

Process of Claim

Claim Process

Go Digit General 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. Availing Treatment
  3. Submission of Claim File

Intimate claim process

How to intimate health claim with Go Digit General Insurance Limited

E-Mail
healthclaims@godigit.com
Claim Helpline
1800-258-4242
Click Here
Register Claim Online
Click Here
Planned Treatment - At least 72 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:-
  • 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
  • Date of Admission
  • 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

  • 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

  • Share the Health Card/Copy of E-Cards along with ID Proof with the Hospital Authority & Obtain the Pre-Authorization Form from the Hospital
  • Submit Duly filled & Signed Pre-Authorization Form to the Hospital Counter
  • Ensure that the Hospital shares the Duly filled & Signed Pre-Authorization Form to Service Provider /Third Party Administrator (TPA) for further Processing
  • Service Provider/ Third Party Administrator (TPA) will inform the decision and may issue authorization letter depending on the Policy Terms and Conditions to the Hospital directly
  • Once the request for Pre-Authorization has been granted, the treatment must take place within 15 days of the Pre-Authorization Approval Date or the Policy Expiry Date whichever is earlier and shall be valid only if all the details of the Authorised details, Hospital and Location including Dates match with the details of the Actual Treatment Received
  • We reserve the right to modify, add or restrict any Network Provider for Cashless Facility in Our sole discretion. Before availing Cashless Facility, please check the applicable updated list of Network Providers
  •  For any queries designated Service Provider / Third Party Administrator (TPA) may be contacted on the contact details mentioned on the Health Card/Copy of E-Cards issued to You
Registered Address
Customer Submit the Claim File in Any Nearby Branch Office

Process of claim

1
Find out whether hospital is in network (https://www.godigit.com/health-insurance/digit-cashless-network-hospitals-list)
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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