Listed below are the processes to claim Aditya Birla Health Insurance Plans.
Cashless Claim
In case you get admitted into any of the network hospitals, you can apply for a cashless claim. In this, the process is fairly simple, wherein you need to provide the following documents at the time of admission:
- Policy document or health card.
- KYC documents of the policyholder and insured (if different).
- Doctor’s advice for hospitalisation.
The hospital would handle the rest of the process and documentation and you would receive the final bill at the time of discharge. You would have to pay only the amount that the insurer does not approve to take the patient home. The insurer would pay directly to the hospital to settle the claim.
Reimbursement Claim
In case of admission to a non-network hospital, you would have to pay for the entire expense from your own pocket and then claim a reimbursement of the same. Here is the process for filing a reimbursement claim:
Inform the insurer
- In the case of emergency hospitalisation, you are required to inform the organisation within a timeframe of 48 hours of being admitted.
- If the hospitalisation is planned, you must inform the organisation 3 days before being admitted.
After discharge, the actual claim needs to be processed.
Submit the documents
- You are required to collect all relevant documents listed from the hospital in their original form.
- Following discharge, these documents should be sent to the appropriate organisation within 15 days.
Claim processing
- Upon receiving the documents, the organisation will conduct a review of the documents as per the terms and conditions.
- Once all necessary formalities are completed, the hospital will process the claim.
Documents Required to Process a Claim of Aditya Birla Health Insurance Plans:
Here is a checklist of documents required to initiate a claim of Aditya health health insurance plan:
Duly filled and signed claim form.
KYC documents of the policyholder.
Doctor’s advice for hospitalisation.
For reimbursement claim, the additional documents are:
Original bills and receipts for medical expenses along with prescriptions.
Investigation report related to the medical condition.
Discharge summary or discharge card issued by the hospital.
Policyholder’s bank account details with a cancelled cheque.
In case of an accident, the FIR (First Information Report) or Medico-Legal Certificate may be required.
