Claim Process - IFFCO Tokio General Insurance

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

How to intimate health claim with IFFCO Tokio General Insurance

Planned Treatment - At least 72 Hrs prior to hospitalization
Emergency Treatment - As Soon possible of hospitalization
E-Mail
healthclaims@iffcotokio.co.in
Claim Helpline
1800-103-5499
Nearest Branch

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:-
  • Health card Membership number
Once the claim is registered, the customer support executive will provide you with a Claim Reference/Intimation Number.

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 7 days of discharge.

 

The claim file has to be submitted at the below mentioned addresses within 7 days of discharge.
Courier Address
Claim documents may also be submitted to local IFFCO TOKIO Office address.




List of Documents

List of claim submission documents are as below

  • Claim form consist of two parts (Part A to be filled by Insured and Part B to be filled by Hospital).
  • Original Discharge summary 
  • Original hospital bill with detailed cost break-up
  • Original Advance and final paid receipts
  • First consultation letter from doctor
  • Indoor Case papers
  • Prescriptions
  • Diagnostic Test Reports, X Ray, Scan and ECG and other films
  • If required claim processing team shall seek further more documents other than the above listed ones.

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 reference 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
IFFCO Tokio 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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