Claim Assistance Guidance
During a medical emergency or property loss, clarity is critical. We provide educational and operational guidance to help you navigate cashless hospital formalities and reimbursement paperwork smoothly.
Cashless Hospitalization Roadmap
Network Hospital Verification
Verify whether the hospital is on the cashless network for ICICI Lombard, HDFC ERGO, or Niva Bupa. Under the 2024–2026 "Cashless Everywhere" initiatives, pre-notification allows cashless treatment at non-empanelled hospitals as well.
Hospital TPA Desk Coordination
Submit your health insurance e-card, government ID (Aadhaar/Passport), and treating doctor’s preliminary diagnosis report to the hospital’s insurance desk.
Initial Pre-Authorization & Query Resolution
The insurer evaluates the initial pre-authorization. If medical queries arise regarding previous ailments or treatment necessity, our advisors guide you on providing the precise clinical history documents.
Final Discharge & Settlement
Upon discharge, the hospital submits the final bill. The insurer settles approved admissible expenses directly with the hospital. Non-medical items (consumables, registration fees) are settled by the policyholder as per policy terms.
Reimbursement Claim Checklist
For planned or emergency treatments outside cashless arrangements:
- ✓ Original signed claim form with attending physician declaration
- ✓ Original discharge summary detailing treatment history and vitals
- ✓ Itemized hospital final bill with breakup and numbered receipts
- ✓ Diagnostic and lab investigation reports with physician prescription slips
- ✓ Pharmacy purchase bills supported by relevant doctor prescriptions
- ✓ Cancelled cheque with printed name/IFSC for direct bank transfer