Health Insurance Claim Process


The general procedure to avail both cashless claims and repayment claims for a medical coverage policy is:

1. Contact the insurance help desk at the emergency clinic.

2. Show the ID card of the policy holder, given by the medical coverage supplier, for the purpose of recognizable proof.

3. The medical clinic will check the identity of the policy holder and will submit the pre-approval form to the health care coverage supplier of the insured.

4. The insurance company will review all the submitted documents and process the case as indicated by the terms and states of the medical coverage policy.

5. Some of the health insurance companies additionally assign a field specialist to make the hospitalization process easier for the policy holder.

6. After the fulfillment all things considered, the claim is settled according to the terms and conditions of the health insurance policy.

List of General Documents Required for Health Insurance Claim Submission:

1. Health Card (Health Insurance ID Card)
2. All the consultation papers provided by the doctor.
3. Completely filled claim form.
4. All the investigation and diagnosis reports, such as CT scan, X-ray, blood reports, etc.
5. In the case of an accident, it is required to provide the copy of FIR.
6. Invoices of the pharmacy with respective prescriptions.
7. Discharge summary report.

Additional relevant documents may be required as per the terms and conditions of health insurance policy.