Importance of Timely Intimation & Submission of Claims
Written on Wednesday, January 7, 2015
By Mr.Narender Anand-SVP & Product Head - General Insurance
Insurance is a business of long-term investment and association. A crucial 'Moment of Truth' for the insured is the experience at the claims stage. This is the time when weÂ gets the opportunity to deliver the promise made to the client.
Timely Intimation &Submission plays a pivotal role in smooth & hassle free claims processing.
Intimation of claim documents
Â A notice of claim with full particulars of the hospitalization has to be sent to the Insurance Company/TPA within 24 hours from the date of admission.Claim intimation can be registered through Call / mail to call center of concern insurer /TPA. You can also mail us email@example.com(mention the intimation number and date in the claim form while submitting the claim documents) for required follow ups.
Kindly forward an intimation of the hospitalization soon after the admission with minimum of following details-
Corporate name (In case of corporate policy )
Exact OR tentative date of admission
Treating doctor name
Submission of claim documents
The Insured should submit all the following original documents to the TPAÂ within given submission period retaining photocopies of all such documents for your own record i.e. within 15 days from the date of discharge for main claim and for post hospitalization, within7Â days from date of completion of post hospitalization treatment
The availability of the followingÂ documents helps in faster processing :-
Duly filled claim form for reimbursement with total claim amount.
Mention TPA Medi card number and TPA claim intimation number (Mandatory)
Enclose intimation mail copy in case of unavailability of intimation number.
Original Hospital Bill / detailed breakup of the final bill / Payment Receipts.
Original Discharge Summary / Card.
All original investigation reports / X-rays films / Scans, ECG etc.
Original Bills and receipts for investigations along with Doctors prescriptions.
Original Bill of Pharmacy, Laboratories along with corresponding original prescription duly endorsed by the treating doctor.
In case of Surgeons/ Consultants bill, kindly insist on a stamped, preferably Numbered receipt.
Hospital Registration Number / Certificate
Any photo ID proof of the patient ( Dully attested by the Hospital )
Bank Detail of Insured :- Copy of cancel Cheque (Digital Name) and Copy of Bank passbook.
Your telephone No / Mobile No / Email I.D.for future correspondence.
Submission of Deficient documents
Query reply to be submitted at TPA desk within 15 days from the 1st Query letter
Timely Intimation & Submission helps in smooth &faster disposal of claims, else its will be a cause of delay &client dissatisfaction