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
Click Here
Register Claim Online
Click Here
WhatsApp Insurer
8169500500
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:-
  • 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

  •  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
1st Floor, HDFC House, Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020

Process of claim

1
Find out whether hospital is in network (https://www.hdfcergo.com/locators/cashless-hospitals-networks))
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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