Health Insurance Claim Submission Instructions

Please submit all scanned copies of required documents through the provided link or mobile application as per the attached document checklist.

⏳ Submission Timeline:

We recommend submitting the documents within 15 days of the settlement date.

🏥 Hospital Eligibility:

The hospital must have a minimum of 15 inpatient beds to be eligible under Mediclaim.
✅ This may not be applicable to well-known hospitals in larger towns/cities.

✍️ Claim Form Instructions:

Before you begin filling out the claim form, please read it carefully.
Mention the following details clearly at the top right corner of the form:

• Employee ID

• Contact Details

• Intimation Number

Mandatory Fields to Fill in the Claim Form:

• ✅ Policy Number

• ✅ Insurance Card Identity Number

• ✅ Name of Insured, Address & Contact Details

• ✅ Corporate Name & Employee Code (for Group Policies)

• ✅ Name of the Patient, DOB, and Relationship with Employee

• ✅ Type of Claim, Date of Admission & Discharge

• ✅ Hospital Name, Address, and Contact Info

• ✅ Details of Illness/Injury

• ✅ Claimed Amount with Bill Numbers

• ✅ All required original documents (as per checklist)

• ✅ Signature of Claimant with Place and Date

Once complete, submit the claim form with all required documents.

📋 Document Checklist:

1. ✅ Original settlement letter with deduction details

2. ✅ Original payment receipt

3. ✅ Attested copy of all medical documents:

   • Discharge summary

   • Final bill with breakup

   • Investigation reports, etc., from the primary insurer/TPA

4. ✅ Filled & signed claim form (attached)

5. ✅ Self-attested Govt. ID proof of both employee and patient

6. ✅ Cancelled cheque of the employee with the name printed on it

🏥 How to Submit a Health Insurance Claim: A Step-by-Step Guide

Navigating the health insurance claim process can feel overwhelming, especially when you’re recovering from a medical event. To make it easier, we’ve put together a complete guide on how to properly submit your documents for reimbursement or settlement through your health insurance policy.

By following the steps outlined below, you can ensure that your claim is processed efficiently and without unnecessary delays.

⏳ Timely Submission Is Key

We recommend submitting all your scanned documents within 15 days of receiving your settlement. This helps ensure your claim is reviewed and processed without complications or rejections due to late submission.

🏥 Hospital Eligibility Criteria

Please note that for Mediclaim purposes, the hospital where treatment was received must have at least 15 inpatient beds.

💡 This requirement may be waived for large, well-known hospitals in major towns and cities.

📋 Document Checklist: What You Need to Submit

To ensure your claim is processed smoothly, make sure to include the following:

1. Original settlement letter with details of any deductions

2. Original payment receipt

3. Attested copies of all medical documents:

   • Discharge summary

   • Final bill with detailed breakup

   • Investigation reports

   • Any other supporting documents from the primary insurer or TPA

4. Completed and signed claim form (attached with your application)

5. Self-attested government ID proof of both the employee and the patient

6. Cancelled cheque of the employee (must have the employee’s name printed on it)