Health Insurance

Claim Process - Kotak General Insurance

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

How to intimate health claim with Kotak General Insurance

Planned Treatment - At least 48 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization
E-Mail
care@kotak.com
Claim Helpline
1800 266 4545

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:-
  • The Health Card We have issued to the Insured Person.
  • The Policy Number.
  • Name of the Policyholder.
  • Name and address of Insured Person in respect of whom the request is being made.
  • Nature of the Illness/Injury and the treatment/surgery required.
  • Name and address of the attending Medical Practitioner.
  • Hospital where treatment/surgery is being taken.
  • Date of Admission.
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 30 days of discharge.
The claim file has to be submitted at the below mentioned addresses within 30 days of discharge.
Courier Address
Family Health Plan (TPA) Ltd,Srinilaya – Cyber Spazio Suite # 101,102,109 & 110, Ground Floor,Road No. 2, Banjara Hills,Hyderabad, 500 034.




List of Documents

  •  Duly completed Claim form signed by You and the Medical Practitioner (only for reimbursement claims)
  • Original Pre – authorization request
  •  Copy of Pre – authorization approval letter
  • Copy of the photo identity document of the Insured Person
  • Original bills, receipts and discharge certificate/card from the Hospital/Medical Practitioner
  • Original bills from chemists supported by proper prescription
  •  Original investigation test reports (including CT/MR/USG/ECG, as applicable) and payment receipts
  • Indoor case papers
  • Medical Practitioner's referral letter advising Hospitalisation in non-Accident cases and referral slip for all investigations carried out
  • Hospital discharge summary
  • FIR or MLC for Accident cases
  • Post mortem report (if applicable and conducted)
  •  Any other document as required by Insurer or TPA to investigate the Claim or Our obligation to make payment for it.

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
Kotak 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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