Health - Cashless Settlement

Cashless claims facility is available only at ournetwork hospitals. This list of network hospitals is enclosed with your policy. Under this facility you just sign the bills at the time of your discharge and we shall settle the amount directly with the hospital.

Under cashless facility, claims can be of two types:

Planned:
Where the insured or covered family member(s) is aware of the hospitalisation 2-3 days in advance.

• Contact our Third Party Administrator (TPA) TTK Health Services help-line at 1800 42 58885 / 1800 42 57878. You can also fax them at the toll free number 1800 233 4535 and call at their landline number 080 23099900. The same is mentioned on the Health Identity Card.
• Fax / submit the pre-authorisation form to TPA with doctor’s comments. This form is available online and also at all our network hospitals.
• The TPA faxes pre-authorisation form with approval within 2-3 hours.
• Avail the health treatment.
• On your discharge, the TPA settles bills with the hospital.

Emergency:
Where the insured or covered family member(s) meets with a sudden accident or suffers from a bout of illness that requires immediate admission to the hospital.

• Rush the patient to the hospital.
• Patient avails the treatment.
• Family contacts TPA help-line at 1800 42 58885 / 1800 42 57878 as mentioned on the health card. You can also fax them at the toll free number 1800 233 4535 and call at their landline number 080 23099900.
• Family submits the pre-authorisation form to TPA with doctor’s comments. This form is available online and with all network hospitals.
• The TPA faxes pre-authorisation form with approval within 2-3 hours.
• On discharge, the TPA settles bills with the hospital.
  
  

Reimbursement Settlement

Reimbursement claims facility is available at both thenetwork and non-network hospitals. The reimbursement claims process is as follows:

• Patient avails the treatment.
• Settle the hospital bills directly by paying the relevant charges.
• Call our TPA at toll free number 1800 42 58885 / 1800 42 57878 and inform about the hospitalization. You can also fax them at the toll free number 1800 233 4535 and call at their landline number 080 23099900.
• Submit the relevant bills / documents for the claimed amount to the TPA.
• The claims will be settled in 7 working days, from the time of submission of bills.
• For any assistance before, during or after the claim, call our TPA at the toll free numbers 1800 42 58885 / 1800 42 57878. You can also fax them at 1800 425 2626 and call at their landline number 080 2520 3771.

Documents Required

• Duly completed claim form (available with all network hospitals).
• Original bills, receipts and discharge certificate / card from the hospital.
• Bills from chemists supported by proper prescription.
• Investigation test reports and payment receipts, supported by the note from attending medical practitioner / surgeon prescribing the test.
• Doctor’s referral letter advising hospitalisation in non-accidental cases.
• Nature of operation performed and surgeon’s bill and receipt.
• Any other documentation / information as required by the TPA.