Medical crisis? Don't despair. We ensure hassle free claims!!

When it comes to planning for medical emergencies, one tends to worry about hospital bills, which could potentially eat into your savings or worse, have you running from pillar to post for arranging the necessary funds. We at Bharti AXA take your emergencies seriously and are always at your service to attend to your medical needs. We ensure that the impact of sudden hospitalization does not wreak havoc on your finances by offering you cashless service through Third Party Administrators (TPAs) at our network hospitals.

Bharti AXA General Insurance offers both Cashless services and Non Cashless (reimbursement) facilities for its customers. You can find our empanelled list of cashless hospitals where claims are managed by Third Party Administrators (TPAs) to offer claims service during hospitalization. To service your claims, reach out to the TPAs in your zone:

• Paramount Health Services: For locations of- Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, Gujarat, Maharashtra, Goa, Madhya Pradesh, Dadra and Nagar Haveli, Daman and Diu, Pondicherry, Andaman and Nicobar Islands and Lakshadweep. Toll free no. – 1800-22-6655
• Emeditek Solutions: For locations of- Jammu & Kashmir, Himachal Pradesh, Punjab, Haryana, Uttar Pradesh, Bihar, West Bengal, Assam, Arunachal Pradesh, Nagaland, Manipur, Mizoram, Meghalaya, Orissa, Tripura, Jharkhand, Sikkim, Delhi, Chandigarh, Uttarakhand, Rajasthan and Chhattisgarh. Toll free no. – 1800-102-3242

How To Avail Cashless Hospitalization Facility?

In case of Emergency Hospitalization in Network Hospitals:

• Patient takes admission in hospital by showing Health ID card
• Cashless claim request form to be filled by the hospital and faxed to TPA at the fax number given in the form or submitted to insurance help desk at the hospital
• TPA will review the claim
• TPA will inform the insured and the hospital with the status via SMS/email notification/fax usually within 6 hours of submission of request
• TPA will approve only the medical expenses covered under the policy. Expenses not covered by the policy are to be borne by the insured
• The hospital bill will be settled by Bharti AXA General Insurance directly

In case of Planned Hospitalization in Network Hospitals:

• Cashless claim request form to be faxed to TPA at the fax number given in the form or submitted to Insurance Help Desk at the hospital 3-4 days before hospitalization
• TPA will review the claim
• TPA will inform the insured and the hospital with the status via SMS/email notification/fax usually within 6 hours of submission of request
• Approach the network hospital with Health card and the confirmation from TPA
• TPA will approve only the medical expenses covered under the policy. Expenses not covered by the policy are to be borne by the insured
• The hospital bill will be settled by Bharti AXA General Insurance directly

In case of Cashless Claim Getting Rejected By TPA:

• Insured can get treatment at the Network Hospital
• All bills are to be paid by the insured and original documents obtained from hospital
• Insured submits the original and necessary documents to the TPA along with claim form
• TPA will review the documents and effect payment within 21 days of receiving the complete documents. If the claim is rejected, a letter will be sent along with the reasons of rejection

How To Avail Reimbursement Facility?

• Insured gets admitted to the hospital
• Takes treatment and pays hospital bills. Gets back all original documents from the hospital
• Submits all original and necessary documents to the TPA along with duly filled claim form
• TPA will review the documents and effect payment within 21 days of receiving the complete documents. If the claim is rejected, a letter will be sent along with the reasons of rejection

Documents Required During Claim Settlement:

Following are the documents required for processing of claim. Depending on the complexity of the case, additional documentation may be called for. All documents to be produced in original

• First prescription of the present illness, for which treatment has been undergone in hospital/nursing home
• Medical advice for hospitalization
• Discharge summary of hospital
• Final bill of the hospital
• Medical fitness certificate
• All test reports supported by medical prescription (pre & post hospitalization)
• All vouchers/bills/receipts pertaining to the tests mentioned above
• All medicines purchased from outside the hospital at any point of time to be supported by original prescription
• Complete and signed claim form with attending doctor’s prescription

The above are only illustrative and not exhaustive.