Claim Intimation Meaning and Importance in Insurance

Posted on: Jan 28, 2026 | 3 mins | Written by: HDFC ERGO Team

Claim Intimation Meaning and Importance in Insurance

Today, insurance is an essential tool for financial security. Whether it is health insurance, life insurance, or motor insurance, these policies protect you against unforeseen events and losses. However, having insurance alone is not enough. You need to follow certain processes to avail the policy benefits, one of the most critical being the claim intimation process. Understanding claim intimation, its purpose, and the correct way to do it can save you from delays, rejections, and unnecessary stress during difficult times

What is Claim Intimation

If you are searching the internet for the claim intimation meaning, here is the explanation.

Claim Intimation is the process of informing your insurance company that you need to make a claim. Claim intimation can be done in several ways. Most insurance companies now offer multiple options, including phone, email, mobile apps, and online portals. Some insurers even offer a 24/7 toll-free number for emergencies.

In health insurance, this is the first step before any claim can be processed. For example, if you are admitted to a hospital due to an accident, you must notify your insurer or the Third-Party Administrator (TPA) as soon as possible. You need to provide details such as your policy number, the reason for hospitalisation, and the expected treatment. This allows the insurer to verify coverage, guide you through the claim process, and, if applicable, approve cashless treatment.

When to Intimate a Claim?

If you have an individual or a health insurance for parents policy, here are some scenarios when you can raise a claim with your insurer:

• You suffered an accident, and your condition requires immediate hospitalisation.

• If you are suffering from a critical illness like cancer or a heart condition and need treatment such as heart surgery or an organ transplant, then, if the policy covers such conditions and procedures, intimation is important.

• If your health policy covers preventive tests or vaccinations, you can file a claim up to the amount mentioned in the policy document.

• You can raise a claim for pre- and post-hospitalisation medical bills, provided they arise from the covered illnesses.

How to Intimate a Health Insurance Claim

You can either make a cashless or a reimbursement claim. Here are the steps involved in both.

Cashless Claim:

• Step 1: Make sure the hospital you are getting admitted to is in the insurer’s network.

• Step 2: At the hospital, go to the TPA (Third Party Administrator) counter, inform them that you want to avail a cashless claim, and show your health insurance card and a valid photo ID.

• Step 3: The TPA desk will send a pre-authorisation request to your insurer.

• Step 4: The insurer will review the request and approve the cashless facility. The hospital will receive an approval letter stating the maximum amount you qualify for for the particular medical treatment.

• Step 5: Once the treatment is completed, the hospital bills are directly sent to the insurer.

• Step 6: At the time of discharge, sign the final documents and pay any non-covered expenses.

• Step 7: After verifying the details and documents, the insurer will pay the hospital directly, and you will receive confirmation of settlement.

Reimbursement Claim:

• Step 1: Get admitted to any hospital of your choice.

• Step 2: Inform your insurer about hospitalisation within 24 hours in case of an emergency. For planned treatment, it is important to notify the insurer 48–72 hours before admission.

• Step 3: Get medical treatment and collect all treatment-related and pharmacy documents.

• Step 4: Submit the documents to the insurer/TPA within the specified timeline. Most insurers require document submission within 15–30 days after discharge.

• Step 5: The insurer will verify the documents and, depending on the claim amount, may send a claim investigator to your home for detailed clarification.

• Step 6: Once the claim is approved, the amount will be directly credited to your bank account.

Documents Required

To raise a reimbursement or a cashless health insurance claim, you need to submit the following set of documents:

• Duly filled and signed claim form

• Health insurance policy copy or e-card

• Identity proof such as aadhaar card, a voter ID, a driving license, or a passport

• Address proof such as a utility bill, aadhaar card, or a passport

• Hospital admission note or admission slip

• Hospital discharge summary

• Detailed hospital bill with break-up of charges

• Payment receipts for hospital bills

• Pharmacy bills with supporting prescriptions

• Diagnostic test reports, such as blood tests, x-rays, scans, or other investigations

• Consultation notes from treating doctors

• Operation theatre notes if surgery was performed

• Implant stickers or invoices if medical devices were used

• First information report or medico-legal case report in case of accident-related claims

• Death certificate in case of a claim for the deceased insured person

• Employer’s certificate in case of group health insurance claim

• Cancelled cheque or bank passbook copy for reimbursement claims

• Pre-authorisation approval letter for cashless claims

• Hospital registration certificate, if required by insurer

Claim Intimation Timeline

For planned cashless treatments, insurers require intimation three to five days before hospitalisation. In an emergency, you need to inform the insurer or the hospital TPA within 24 to 48 hours of admission.

If you are filing a reimbursement claim, submit the documents as soon as possible to avoid any hassle, ideally within 15 days.

Note: The claim intimation timeline varies with the insurer. It is recommended to read the policy document to understand the exact claim procedure and timelines.

Conclusion

Claim intimation officially triggers the claims process. Without this step, an insurer cannot begin assessing or investigating the case, which delays everything that follows. In many insurance contracts, failure to intimate on time can even be grounds for claim rejection if not properly justified.

In general, early reporting helps insurers preserve crucial evidence, whether it is an accident scene, medical documentation, or loss details, which aids investigation and verification.

To maximise medical insurance benefits, it is recommended to use a health insurance calculator to choose the ideal sum insured based on your current health and age.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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