Claim Process - Max Bupa Health Insurance

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

How to intimate health claim with Max Bupa Health Insurance

Planned Treatment - At least 72 Hrs prior to hospitalization
Emergency Treatment - Within 48 Hrs of hospitalization
E-Mail
customercare@maxbupa.com
Claim Helpline
1800-3010-3333
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:-
  • Policy number.
  • Name of Policyholder.
  • Name of Insured Person in respect of whom the claim has been notified.
  • Name of Hospital with address and contact number.
  • Diagnosis and Treatment undergone (medical / surgical management with name of surgical procedure undergone, if applicable) 
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 &  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 &  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
Max Bupa Health Insurance Company Limited, B-1/I-2, Mohan Cooperative Industrial Estate, Mathura Road, New Delhi-110044.




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).
  • Self attested copy of valid age & identity proof (Passport/Driving Licence/Pan card/Voter identity card/Class x Certificate/Birth Certificate)
  • Cancelled cheque
  • Original discharge summary
  • Bar code sticker and Invoice for Implants and Prosthesis (if used)
  • Indoor case paper/OT notes (if required).
  • Original final bill from Hospital with detailed break-up and paid receipt.
  • Original bills of pharmacy/medicines purchased, or of any other investigation done outside hospital with reports and requisite prescriptions.
  • Copy of death certificate (in case of demise of the Insured Person).
  • MLC/First Information Report (FIR) copy attested by the concerned hospital / police station (if applicable)
  • Original first consultation paper (in case Illness disease is diagnosed for the first time)
  • Original laboratory investigation, diagnostic & pathological reports with supporting prescriptions.  
  • Original X-Ray/ MRI / ultrasound films and other radiological investigations.

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
Max Bupa 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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