Reimbursement claim must be intimated within 24 hours of admission and claim documents must be submitted within 7 days from the date of discharge from the hospital.
1. Claim form duly (Part A and Part B) signed by the claimant.
2. Prescription details by treating doctor/surgeon.
3. Original hospital discharge card/summary mentioning the date of admission, date of discharge, diagnosis, presenting complaints, past history, clinical findings, a course in the hospital, treatment given during the period of hospitalization, and advice at discharge.
4. Original pre-numbered hospital bill with hospital seal and signature indicating complete details of break-up and hospitalization period.
5. Original pre-numbered paid receipt with hospital seal and signature towards the final hospital bill.
6. Original of all laboratory & diagnostic test reports. E.g. X-Ray, E.C.G, Ultrasound, MRI Scan, Haemogram, etc.
7. If you have purchased medicines that have not been reflected in the hospital bill, please enclose a prescription from the doctor and the supporting stamped medicine bill/receipt from the chemist.
8. If you have paid for Diagnostic or Radiology tests and it has not been reflected in the hospital bill, please enclose a prescription from the doctor advising the tests, the actual test reports, and the stamped bill/receipt from the diagnostic center for the tests.
9. Photocopy of valid ID proof of patient and employee.
10. Cancelled Cheque of Employee with pre-printed name on it. Complete NEFT details need to be filled in claim form/EFT form as applicable.
11. Please enclose the IOL sticker in case of Cataract operation if covered in the policy.
12. Original implant sticker/invoice.
13. Indoor Case Papers (ICP) in few cases post a review of Initial documents. Note – Above document checklist is a standard checklist for health insurance claims. On a case-to-case basis, the insurer/TPA may ask for any additional documents based on the requirement.
In case of any query, you can reach us at 96966 83999 / 99109 13339 or support@securenow.in