Following documents in original are required for processing your claims on reimbursement basis:

  1. Claim Form properly filled and signed by the claimant
  2. Discharge Certificate from the hospital
  3. All documents pertaining to the illness starting from the date it was first detected i.e. Doctor's consultation reports/history
    1. Bills, Receipts
    2. Cash Memos from hospital supported by proper prescription
    3. Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics. Surgeon's certificate stating the nature of the operation performed and surgeon's bill and receipt
    4. Attending doctor's / consultant's / specialist's / anesthetist's bill and receipt, and certificate regarding diagnosis
    5. Certificate from the attending medical practitioner / surgeon that the patient is fully cured
    6. Photocopies of previous policies : if the details are not already with us except in the case of accidents

All bills in original and a discharge certificate are to be left with the hospital providing cashless treatment. The patient has to countersign all bills and fill the claim form and also leave the same with the hospital at the time of discharge. A copy of the bills & Discharge Summary can be carried by the patient for his records and for submission along with Pre & Post Hospitalization bills.

Yes. Mediclaim policy does not cover a few diseases which have occurred within the first/second year of policy commencement depending upon the policies. Diseases which are not payable during the first/second year of the operation of insurance cover are:

  • Cataract Benign Prosthetic Hypertrophy
  • Hysterectomy for Menorhegia or Fibromioma
  • Hernia, Hydrocele
  • Congenital, Internal Diseases
  • Fistula in anus, Piles, Sinusitis

You need to contact your Insurance Company for any addition / deletion of the above type. Once we get a notification from them, we will update our records similarly.

Yes, subject to the limit of the sum insured. Your mediclaim policy covers 30 days Pre-hospitalization expenses and 60 days Post-hospitalization expenses. You may lodge your Pre-hospitalization claim along with hospitalization claim. The Post-hospitalization claim may be lodged within 7 days after expiry of the treatment or 60 days after discharge from the hospital whichever is earlier. However, please quote your Claim Number for easy referral and sorting

Yes it is possible to shift to another hospital for reasons of requirement of better medical procedure. However, this will be evaluated on the merits of the case and as per policy terms and conditions.

No. The TPA Card is issued to you against your mediclaim policy which only covers hospitalization expenses. The outpatient / domiciliary expenses pertaining to the treatment of disease which is the cause of hospitalization is however covered (Please see Pre & Post Hospitalization benefits)

There could be a chance that the Insurance Company has still not forwarded your details to us. Also there is a possibility that your card has been dispatched and you have not received the same. You can call our call center and they will guide you suitably. Alternatively, you can enter the policy number at our website ( ) and you can get your card status.

You may immediately call our call center, giving details of such hospitals/medical providers. Our network department will immediately contact the concerned medical provider and sort out the matter.

Yes. Under the Mediclaim Policy, you can opt for CashLess as well as Reimbursement. We would advise that in case you are taking treatment from a network hospital, then you should avail of the Cash Less facility. This will give you the financial advantage of not paying for your hospital treatment and also give you more cushions to meet your post-hospitalization expenses.

Yes. The TPA service is of All-India nature. You can access any of our offices and in the event of an hospitalization, use the services of any network hospital spread across the country.