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Health Insurance

Process of Claim

Claim Process

HDFC ERGO 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 HDFC ERGO General Insurance

E-Mail
healthclaims@hdfcergo.com
Claim Helpline
022-6234-6234/ 0120-6234-6234
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Register Claim Online
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WhatsApp Insurer
8169500500
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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

To Register claim by calling on above contact point, you will need to provide the following information to the customer support executive:-
  • 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.
  • Date of Admission to Hospital or proposed date of admission to hospital for Planned Hospitalization.
  • Date of Discharge
  • Email ID
  • Approximate Claim Amount
  • 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 & 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.
List of Documents

Documents require for claim process

  • Duly filled & signed claim form
  • All hospital bills in original including final hospital bill (with bill number signed & stamped by the hospital) with itemized bill & original receipts
  • Discharge card or discharge summary (original) or death certificate in case of death (in hospital)
  • All original investigation reports & medicine bills with doctor’s prescription.
  • Follow-up advice or letter for line of treatment after discharge from hospital from doctor.
  • In case the hospital is not registered, please get letters on the hospital letterhead mentioning the number of beds and availability of doctors and nurses round the clock.
  • In case of non-network hospital, you may have to get the hospital and doctor’s registration number in hospital letterhead and get the same signed and stamped by the hospital, if required.
Registered Address
1st Floor, HDFC House, Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020

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 ref 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
HDFC Ergo 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.
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