Claim Process
Claim Process
Hassle-free Claim Settlement
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Health Insurance

Claim Procedure:

Health Claims can be broadly categorized in to two types:

1. Cashless Claim
2. Reimbursement Claim

Procedures for Cashless Claim

Cashless claim is the service wherein you need not pay your hospitalization bills to the hospital either at the time of admission or at the time of discharge from the hospital. Cashless claim for medical treatment is available only in network hospitals.

To avail the cashless facility you need to fill "Cashless request form" available in all the network hospitals. The hospitals will co-ordinate to get the authorization from the HCS/TPA for such cashless facility. This authorization along with a copy of the card issued by us needs to be given to the hospital at the time of admission. You are also required to carry a Photo Id Card.

Cashless facility may be denied by the HCS/TPA in some of the situations as listed below.

  • If the information sent by you /hospital is insufficient
  • The ailment/condition is not covered under the policy
  • If the request for preauthorization is not sent in time

Denial of cashless facility is not denial of treatment. You may continue with the treatment by paying the hospital for the services, and later submit the claim for processing and reimbursement.

 

" All claims are subject to approval by Surveyor appointed by HDFC ERGO GIC LTD "

 


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