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The Process To Claim Health Insurance

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In today’s time, the risk of facing health challenges has increased to an all-time high. It is because of this reason that having a health insurance policy has become so vital. It serves as a safety net that can provide you and your loved ones with the necessary support during any medical issue. By providing coverage for pre and post-hospitalization, treatment and other costs, it reassures you that when any unforeseen health challenge strikes, you will be able to get quality healthcare facilities without facing any financial difficulties.

When you have a health insurance plan, you can avail many benefits like extensive coverage up to Rs. 1 crore, tax-saving benefits and option to buy critical illness cover. The plan covers you for pre-existing illnesses, pre and post-hospitalization, maternity expenses and many other treatment costs. While all such benefits offer you reassurance and a sense of security, what often causes you worry is going through the claim process.

When you or your loved ones are facing a medical condition, you do not have the time and energy to go through a difficult claim process.

However, Bharti AXA General Insurance keeps this concern of policyholders in mind and offers a simple and straightforward claim process. It ensures that at the time of medical emergency, you know how to go about with availing healthcare facilities without any worries at the back of your mind.

When you have Bharti AXA’s health insurance policy, you need to know the following things about its claim process:

The two ways in which your health insurance claim will get settled are as follows: 

  • Cashless Claim
  • Reimbursement Claim

Whether you choose cashless claim settlement or reimbursement, you need to keep claim notification in mind firstly. In doing so, you need to take the following steps:

  1. Contact us through any of our 24x7 convenient intimation modes, such as:

 

 

  1. Share all relevant and necessary details included in the claim notification such as the name of the insured and covered person, policy number, contact details, nature of the disease, name and address of the hospital, date of hospitalization and other such information.

Note that your claim notification must reach Bharti-AXA General Insurance (BAGI) within 48 hours of admission or discharge from the hospital, whichever is earlier. Our team will dispatch the claim form on receiving the notification.

The claim form is available with all our network hospitals and you can also obtain it from any of our offices. To fill the form online, click here to download.

However, if the treatment is not covered under your policy, a letter stating the reasons for rejection will be sent to you.

 

Cashless hospitalization

Our cashless hospitalization service covers a network of 4500+ hospitals.

  1. Upon admission, whether for a planned procedure or during an emergency, you will need to tell your treating doctor to fill a preauthorization request form.

 

  1. We will then take action within 6 hours of receiving all the documents and formalities for emergency admission, or 48 hours in case of planned admission.

 

  1. You will receive authorization for emergency admission within 6 and 48 hours of receiving the form in case of emergency and planned procedure, respectively. Also, if your cashless claim is rejected, it does not mean that your application will not be settled at all. We will examine claims on individual merit and you will receive reimbursement later if the request is accepted.

You will not need to make any payment to the hospital if you receive the authorization letter, except under the following cases:

  • The bill amount exceeds Sum Insured.
  • There are some non-medical expenses or unrelated treatment
  • There is any Excess or deductible to be borne by you
  • You might have to pay the difference if the authorized amount is less than the estimated or actual bill amount.

 

Reimbursement Claims

In case of filing for reimbursement claim, ensure that you intimate us within seven days from the date of discharge. However, you can send the documents within 30 days if you have been admitted to a non-network hospital. Further, you can send the pre- and post-hospitalization bills within 15 days from the end of the post-hospitalization period as specified in the policy.

After the submission of requisite documents, we will settle your claim within 30 days. In case your treatment is not covered under the policy, you need to pay all bills and send us the claim form and other original and necessary documents.

Under the regular settlement, we will effect payment within 21 days after receiving all documents.

However, if your claim is rejected, you will receive a letter explaining the reason for the rejection.

 

When you buy Bharti AXA’s health insurance policy, you can enjoy a significant sense of security and a smooth claim settlement procedure. Buy one of the best health insurance plans that best suit your needs and secure your loved ones.

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Disclaimer :The information published on this website is for the public's reference only. Content of this information is to provide an overview of your Insurance needs and should not be relied upon for personal, medical, legal or financial decisions and you should consult an appropriate professional for specific advice for Travel/Health/Motor. Bharti AXA General Insurance Company Limited makes no representations about the suitability, reliability, timeliness, and accuracy of the information, travel, services, or any other items mentioned on this subject for any purpose whatsoever.

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