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Health Insurance Claim Process

The good things in life can last forever

In our endeavour to provide you the best coverage along with a host of other value added services, our online General Insurance claims system has been designed keeping your ease in mind. With a convenient claim process for your health insurance policy, you can now register your claim, upload the necessary documents and know the status instantly.

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HEALTH INSURANCE CLAIM PROCESS

Register your health insurance claim


MY ABHA


Register Claim Online Network & Excluded Hospital List


Instructions to fill the claim form

Click here

Online Claim Submission
Reimbursement Claim Form OPD Claim Form Cashless Request Form


Personal Accident claim form
Click here


Check Claim Status

Dial our Toll Free Number


1800-209-5858

Email us on


bagichelp@bajajallianz.co.in
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  • Health Claim Process

  • Check List

  • Product List

Other Products

  • 1

    Your doctor advises treatment or hospitalization

  • 2

    Intimate the claim on your health insurance

  • 3

    Visit Network hospital (For cashless claim) or Visit a hospital of your choice and pay accordingly (For reimbursement claim)

  • 4

    TPA desk of network hospital contacts BAGIC for cashless treatment (For cashless claim) or Submit original hospitalization related documents to BAGIC -HAT upon discharge (For reimbursement claim)

  • 5

    TPAs with us

List of TPAs associated with us

Medi Assist Insurance TPA Pvt Ltd


Family Health Plan Insurance TPA Pvt Ltd.(FHPL)


 Paramount Healthcare Services Pvt Ltd.

 Good Health Insurance TPA Pvt Ltd.(GHPL)

 Vidal Health Insurance TPA Pvt Ltd.

 MDIndia Insurance TPA Pvt Ltd.

 Health India Insurance TPA Pvt Ltd.

 Volo Health Insurance TPA Private Limited.

Life is an unpredictable roller-coaster ride. But amidst all the volatility, you can bank on us for being there by your side, all the time.


Should you want to file your health insurance claim online, click here. Conversely, you can also reach out to us at our Toll Free Number at 1800-209-5858 and we will be glad to help you out.


For Cashless Health Insurance Claim

While we drink to your good health, in case of any untoward incident



  • Approach any of the Bajaj Allianz Network Hospitals for complete cashless facility
  • The hospital will verify your details and send the duly filled pre-authorization form to Bajaj Allianz – Health Administration Team (HAT)

  • We will duly verify the details of the pre-authorization request with the policy benefits and intimate our decision to the healthcare provider within 1 working day


Yay! Your cashless claim is approved



  • We send the First response to your healthcare provider Within 60 mins

  • Your treatment costs at our network hospital will be settled by us and you don’t have to worry about the medical bills


It seems we have a query



  • We will send a letter of query to the healthcare provider, asking for further relevant information that will allow us to initiate the Health Insurance claims processes faster

  • Once we receive the additional information, we will send the authorization letter to your healthcare provider within 7 working days

  • Our network hospital will treat you and you won’t have to worry about the medical bills

We’re sorry, your claim is denied



  • We will send the letter of denial to the healthcare provider

  • The provider will carry out the treatment, as fully payable

  • However, you can certainly file a claim for reimbursement at a later date
For Health Insurance Reimbursement Claim

While we drink to your good health, in case of any untoward incident



  • Collect all hospitalization related documents and submit them, in original, to BAGIC HAT

  • We will carry out a customary verification of the required documents


Oh, we need some more information



  • We will send you a prior intimation of such deficiency so that you have sufficient time to provide further information

  • Upon receiving the requisite documents and some more enquiry, you can bank on us to initiate the insurance claims settlement process and release the payment via ECS within 10 working days (may be subject to terms and conditions)

  • In case you still fail to provide us with the pending paperwork, we will send you three reminders, each 10 days apart, from the date of intimation

  • However, please note that we will be forced to close the claim and send you a letter stating the same if you fail to come up with the pending documents beyond 3 reminders (30 days) from the date of intimation


Yay! Your claim is approved


We initiate a customary verification of the authenticity of the documents and if found permissible within the policy’s purview, we will release the payment via ECS within 7 working days.


However, if your General Insurance claim doesn’t fall within the policy’s purview, we will have to deny the claim and send you a letter stating the same.

Claim Forms

Please fill the required claim form below, based on the nature of your claim.

  • Hospitalization Claim form duly filled and signed by the insured
  • Original Discharge summary document
  • Original hospital bill with detailed cost break-up
  • Original paid receipts
  • All Lab and test reports
  • Copy of Invoice/Stickers/barcode in case of implants
  • First consultation letter from doctor
  • KYC form
  • Completely filled and signed NEFT form by Policy Holder/proposer
  • Claim form duly filled and signed by the insured
  • Original Death summary document
  • Original hospital bill with detailed cost break-up
  • Original paid receipts
  • All Lab and test reports
  • Copy of Invoice/Stickers/barcode in case of implants
  • First consultation letter from doctor
  • KYC form
  • Legal heir certificate containing affidavit and indemnity bond
  • Completely filled and signed NEFT form by Policy Holder/proposer.
  • Claim form duly filled and signed by the insured / Claimant.
  • Beneficiary Name against the Policy and NEFT Details of Insured / Nominee
  • Completely filled NEFT details stating Branch, Branch IFSC Code, Account type, Complete Account Number duly signed by Nominee / Claimant with original pre printed cancel cheque if pre-printed cheque is not available Kindly provide 1st Page of Bank Pass Book/ Bank statement Attested by the Bank which clearly indicates Beneficiary Name & Complete Account no as well IFSC code.(All Fields in the form are mandatory to process).
  • Aadhar Card & Pancard details of Nominee / Claimant/ Insured.
  • KYC form
  • We will require Salary Slip/ ITR at the time of issuance of the policy for Salary Commensuration.
  • Original Discharge Summary.
  • All the previous Consultation Papers
  • Investigation Reports supporting the diagnosis.
  • Operation Theatre Notes
  • Original Final Bill with detailed bill break up and Paid Receipts
  • Original Pharmacy and Investigation Bills
  • Attested copy of Death certificate
  • Attested copy of FIR / Panchanama / Inquest
  • Attested copy of Post Mortem Report
  • Attested copy of Viscera /Chemical analysis Report if any
  • Hospitalization documents, if any
  • In case of Death if Nominee is not defined on the policy copy then we will require the below documents
  • Legal heir certificate containing affidavit and indemnity bond on 200 INR (As per attached format).The same should be duly signed by all legal heirs, notarized.
  • If Nominee is minor then we will require Decree Certificate from Court stating the guardian of the insured
  • Duly filled Medical Certificate attached in the Personal Accident Claim Form.
  • X-ray films /Investigation reports supporting the diagnosis.
  • Permanent Total Disability and Permanent Partial Disability Certificate from the Government authority certifying the disability of the insured.
  • Photograph of the patient before and after the accident to support the disability.
  • Duly filled Medical Certificate attached in the Group Personal Accident Claim Form
  • Leave certificate from employer stating the exact leave period, duly signed and sealed by the employer.
  • All the consultation papers with details of treatment during TTD period.
  • Final medical fitness certificate from treating doctor stating the type of disability, disability period and declaration that patient is fit to resume his duty on given date.
  • X-ray films /Investigation reports supporting the diagnosis.
  • In Case of Death and PTD, Kindly provide bonafide certificate from the school authorities stating that child of the insured is studying over there. (Mentioning - Name, S/D/o, Date of Birth and Class) School Identity Card.
  • Burial Expenses & Transportation Expenses Original Paid Receipts
  • Copy of Final Bill and Discharge Summary.
  • Investigation reports toward diagnosis.
General Insurance FAQs

LET’S SIMPLIFY

What is a cover note?

It is a temporary insurance certificate that your insurer will give you, prior to the issuance of a policy. This is after you have duly filled and signed the proposal form and paid up the premium in full.

It is valid for a period of 60 days (from the date of its issue) and warrants the Insurance Company to furnish the insurance certificate before the expiry of the cover note.

What if I want to make certain changes within the policy?

The term you might be looking for here is endorsement, which is an agreement in writing, concerning changes in your insurance policy. An endorsement can be put into action during issuance of the policy in order to introduce add-ons and a more extensive coverage or impose certain restrictions.

What is a No Claim Bonus?

You will be eligible for a No Claim Bonus (NCB) in case you don’t make a single insurance claim over the course of your policy. It reduces the premium on your car insurance policy and is a token for you being the good driver that you are.

NCB can be transferred to a new vehicle belonging to the same class and is valid for a period of 90 days from the expiry of your motor insurance policy. However, if the new mean machine is more expensive, you might be charged an additional administrative fee in addition to a higher insurance premium.

What is the Family Floater Health Guard policy?

While an Individual Health Insurance policy restricts its coverage to the policy holder, a Family Floater Health Guard policy makes it convenient for any member in the family to utilize the sum insured.

What to do when my policy expires?

Keep Bajaj Allianz on your speed dial and give us a holler on our Toll Free Number 1800-209-5858 in case your policy expires. We are working 24 hours, just to provide you a hassle-free insurance experience!

Can NRI’s opt for health insurance? Will they be able to travel to India for subsequent treatment and claim?

Yes, NRI’s can opt for health insurance in India. And they can surely come to India to get the condition treated and eventually claim the sum assured.

All they will have to do is present a few relevant documents such as proof of residence, ITR, etc. Eligibility for insurance can take a hit if they cannot present these documents.

How to claim with planned/emergency hospitalization?

Keep all your documents updated and ready. Nothing beats the significance of this principal that should hold you in good stead all the time.

With any history of medical condition in the past, be honest about it and keep such documents handy at all times. This is because eventually the TPA will find out if that is a pre-existing condition or not.

Please note that you should inform your Health Insurance Company in advance and take an authorization letter beforehand.

Can I register my claim online?

Absolutely! If calling our Toll Free Number doesn’t work out for you, you can always register your claim online.

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Disclaimer

I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back at a convenient time. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

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