Health Insurance Claim Process
Step-by-step guide to filing health insurance claims. Learn the cashless and reimbursement process, required documents, and how to avoid claim rejection.
Cashless Claim Process
Intimate Insurer
Inform insurer within 24 hours of emergency admission or 3 days before planned treatment.
Visit Network Hospital
Go to a network hospital and present health card and photo ID at the insurance desk.
Submit Pre-Authorization
Hospital fills pre-auth form with treatment details and estimated cost, sends to insurer.
Get Approval
Insurer reviews and approves cashless request, usually within 2-4 hours.
Treatment & Discharge
Get treated. Hospital settles bills directly with insurer.
Pay Non-Covered Amount
Pay only for items not covered (consumables, documentation charges).
Reimbursement Claim Process
Intimate Within 24-48 Hours
Inform insurer about hospitalization within specified time (24-48 hours for emergency).
Get Treated
Get treatment at any hospital. Pay all bills from your pocket initially.
Collect All Documents
Gather original bills, discharge summary, reports, and all medical documents.
Submit Claim Form
Fill claim form and submit with all documents within 15-30 days of discharge.
Claim Processing
Insurer verifies documents and processes claim (usually 15-30 days).
Receive Reimbursement
Approved amount credited to your bank account.
Documents Required for Claim
Keep all original documents safely. Submit within the time limit specified in your policy.
Tips for Smooth Claim Experience
- Keep health card accessible at all times
- Save insurer helpline number in phone
- Intimate insurer within time limits
- Collect all original documents
- Keep copies of submitted documents
- Follow up on claim status regularly
Frequently Asked Questions
Learn More About Health Insurance
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