CLAIM PROCESS

1. If the Insured intend to make any claim under this Policy

  • Intimate TPA in writing on detection of any Illness/Injury being suffered immediately or forty eight hours before Hospitalization.
  • Intimate within twenty four hours from the time of Hospitalization in case of Hospitalization due to medical emergency.
  • Submit following supporting documents TPA relating to the claim within seven days from the date of discharge from the Hospital:   
    • Bill, Receipt and Discharge certificate / card from the Hospital.
    • Cash Memos from the Hospitals (s) / Chemists (s), supported by proper prescriptions.
    • Receipt and Pathological test reports from Pathologist supported by the note from the attending Medical Practitioner / Surgeon recommending such Pathological tests / pathological.
    • Surgeon's certificate stating nature of operation performed and Surgeons’ bill and receipt.
    • Attending Doctor's/ Consultant's/ Specialist's / Anesthetist’s bill and receipt, and certificate regarding diagnosis.
  • In case of Post-Hospitalisation treatment (limited to sixty days), submit all claim documents within 7 days after completion of such treatment.
  • Provide TPA with authorization to obtain medical and other records from any Hospital, Laboratory or other agency.

The Insured person shall submit to the TPA all original bills, receipts and other documents upon which a claim is based and shall also give the TPA/Us such additional information and assistance as the TPA / We may require.
Any Medical Practitioner authorised by the TPA/Us shall be allowed to examine the Insured Person, at our cost, if We deem Medically Necessary in connection with any claim.