FOR CASHLESS FACILITY AVAILABLE ONLY FOR POLICIES SERVICED BY A TPA

a. Check if the hospital falls under the networked hospitals or not, as cashless is available only for networked hospitals.

b. For planned hospitalisations, intimations to be sent to the TPAs in advance with details of:

• Name and address of the hospital,

c. In case of an emergency hospitalisation, intimation to be sent to the TPA immediately on admission.

d. On admission, a Pre-Authorisation Request for cashless is to be sent to the TPA by the hospital – duly signed by the insured and Hospital Authorities giving the details of admission, illness, proposed line of treatment and the estimated expenses.

e. Please furnish clarifications if any required by TPA.

f. On discharge from Hospital, please pay the difference of amount disallowed under the policy or limited by the sum insured.

g. Pre and post hospitalisation expenses can be claimed separately after treatment. All documents in original to be submitted within 7 days to TPA, after completion of Post Hospitalisation treatment.

FOR REIMBURSEMENT CLAIMS:

a. Written intimation about hospitalisation to be sent to TPA / our office (if non TPA) immediately, and within 24 hours of hospitalisation in the case of emergency hospitalisation.

b. Before leaving the hospital, Discharge Summary, Copy of investigation report and other relevant documents may be obtained from the hospital authorities. All the documents in original to be submitted to TPA / Office within 7 days from date of discharge.

c. Documents include claim form issued by insurer, discharge summary of hospital, doctor's certificates and prescriptions, final hospital bills, laboratory and other investigation reports and bills, pharmacy bills and all related documents.

d. Pre and post hospitalisation expenses can be claimed separately after treatment. All documents in original to be submitted within 7 days after completion of Post Hospitalisation treatment.