Health Insurance

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Due to the escalating cost of medical care, every person must purchase health insurance for themselves and their family. In the digital era, it is no longer essential to visit the insurance company’s branch office to submit hospitalisation documents physically to claim health insurance.

Medical insurance apps have highly simplified the claiming process. With the app-based paperless claim settlement feature, physical submission of bills, and hospital papers may not be required anymore.

Register and upload health claim documents on the app. Get your health claims settled quickly and easily

To understand the claim process through an app for health insurance, like Health CDC (Claim by Direct Click) on the Caringly Yours app by Bajaj Allianz, let’s first evaluate the two types of claims.

  1. Cashless: In the event of a cashless claim, the patient does not have to pay any money at the hospital counter right away. The insurance company would settle the accounts with the hospital on behalf of the insured person. The cashless health insurance option would only be available if the hospital has a contract with the insurance company and the policy covers the illness.
  2. Reimbursement: If the cashless claim option doesn’t work, the insured can use the reimbursement claim option. In this case, the patients can claim the money they spend on medical care from the insurance company later. Claim by Direct Click or CDC feature in the Caringly Yours app lets you sign up and upload documents about your health claim through the app directly.

* Standard T&C Apply

You can easily file reimbursement claims through the health insurance app by following these steps.

Step 1: File for reimbursement claim

The insured person must file a claim for reimbursement with the insurance company within 30 days of getting out of the hospital. The claim form can be filled out on your health insurance app within minutes. After submitting the relevant details of policy, treatment and hospital in the claim form, a claim number will be generated. *

Step 2: Documents

The insured has to get the hospital’s stamp on all the pre and post-hospitalisation bills and reports for which he is making a claim.

After the claim number is generated, the policyholder will have to upload pictures of the claim documents on the medical insurance app. They need to be uploaded in a proper sequence to avoid confusion. Also, the images or pdfs need to be clearly readable. The order followed generally is –

  1. Duly signed and stamped claim form
  2. NEFT details of the insured’s bank
  3. Discharge summary that includes details on the diagnosis, treatment given, medications prescribed, follow-ups, date of admission and discharge etc.
  4. Hospital bills and payment receipts, including main bill and supplementary invoices like CT scan charges, pharmacy costs etc.
  5. Investigation reports such as MRI scans, blood reports etc
  6. Any other hospitalisation documents such as doctor’s prescription

Step 3: Wait for payment to be processed

Once the company gets the documents, they will call the customer and the hospital to verify your claim. The claim would then be judged based on the documents that were uploaded.

Once medical eligibility is confirmed, the insurance company pays the claim ideally within a short amount of time.

Filing a health insurance claim through a Bajaj Allianz mediclaim app, is quick and as easy as a cakewalk.

However, remember that the facility currently cannot be utilised for big-ticket reimbursement claims. You need to follow the standard route of submitting hard copies in claims above Rs. 20,000. *

* Standard T&C Apply

‘Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale. ‘

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