It is important to understand the claim procedure of your insurance provider to get the benefit of insurance coverage. Claims can be filled on a cashless as well as reimbursement basis. For planned hospitalisation, notify the insurance company before hospitalisation within the timeline mentioned in your policy. For emergency hospitalisation, you have to inform the insurance company within 24 hours of hospitalisation.

1. Cashless Claims – Cashless claims can be availed at network hospitals only. Inform the hospital about your senior citizen’s health insurance plan and provide the policy details and all the required documents. The insurance helpdesk at the hospital will guide you through the process and coordinate with the insurance company for claim approval. Once approved, your hospital bills will be settled directly by the insurance company at the time of discharge.
   
   
2. Reimbursement Claim – If you are seeking treatment at a non-network hospital, you can file for a reimbursement claim. You will have to pay the bills at the time of discharge. Later you can submit your claim form with all the necessary documents to the insurance company. Your claim request will be verified and if approved the claim amount will be reimbursed.
   
   
3. OPD care, Critical illness, and Pre and post-hospitalisation Claims – For OPD and Pre and post-hospitalisation claims, fill out the claim form and provide all the medical bills, doctor’s statements, and consultation papers to the insurance company within the specified timeframes. The claim amount is reimbursed after verification and approval. For critical illness claims, once the diagnosis is confirmed, inform the insurance company and provide all the medical reports and documents confirming the diagnosis. Remember to notify within the timeframes for approval of your claim request. Once the claim is approved, the claim amount is credited to your account.