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At Religare Health Insurance, the principal purpose for our existence is to ensure that our customers enjoy quick & hassle-free access to best-in-class healthcare delivery facilities, and we live this objective through our seamless claim process. Our 4900+ network of hospitals make the claim management quick and convenient for you.

Please note - For Reimbursement claims only -

Claim payments are made through Online Bank Transfers only. Please submit cancelled cheque of the policy holder and relevant details as mentioned in Section G of the Claim Form, when applying for a reimbursement claim.

Please submit original documents (mentioned below) for speedy claim disbursal. Indoor Case Papers - This document is prepared by hospital on daily basis which maintains daily doctor notes, nursing notes, patient progress details and having patient condition summary from the date of admission till discharge Hospital Discharge Summary - Summary of hospitalization period including – Admission date, discharge date, diagnosis, line of treatment given to patient during hospitalization and further advice on discharge. Payment Receipts – Receipts of payment done to hospital authorities towards all bills, investigation reports or any other procedure done. Consultation Papers – Written prescription of the Medical Practitioner with whom patient has consulted.

Claim process in case of Cashless Treatment at Network Hospitals

Step 1 : Claim Intimation

  • In case of an emergency hospitalization, call and inform us at 1800-200-4488 within 24 hours of your admission. However, if your hospitalization is planned, kindly intimate us 48 hours prior to your admission by calling on the same number or writing to us at customerfirst@religarehealthinsurance.com

Step 2 : Initiating the process for Pre-Authorization

  • A Pre-Authorization form will be available at the hospital's Insurance/TPA desk, or you can alternatively download the same from here.
  • Please fill the first section of the form by giving your personal details and hand over signed Pre-Authorization form to hospital's Insurance/TPA desk for them to fill up the balance details.
  • Hospital will fax the completed Pre-Authorization form to us at 1800-200-6677.

Step 3 : Processing a request for Pre-Authorization

  • Our in-house medical team will review the case and documents submitted by hospital.
  • If your request for Pre-Authorization is approved, you and the hospital will be duly informed by us.
  • In case of any information deficiency or further information requirement, you and the hospital will be regularly intimated by us to ensure resolution of the same at the earliest.
  • If your request for Pre-Authorization is not approved, it only indicates that we are not able to process your request basis the requisite information available with us at this point of time. In such cases, you may claim for reimbursement of your expenses after discharge from the hospital.


Reimbursement of treatment expenses

Step 1 : Claim Intimation
In case of emergency, call and inform us within 24 hours of your admission. However, if your hospitalization is planned, kindly intimate us 48 hours prior to your admission. The following information is to be provided during the claim intimation-

  • Policy Holder's Name.
  • Claimant's Name & Customer ID.
  • Hospital details.
  • Diagnosis and Treatment details.
  • Approximate claim amount.
  • Date of admission

We will provide a reference ID for all future communication pertaining to the claim request.

Step 2 : Initiating the Claim process (Also applicable for Pre/Post Hospitalization claims)
The Claim form can be downloaded from here.

The completed and duly signed claim form has to be sent to us along with the following documents -

  • Duly completed and signed Claim form, in original
  • Valid photo-id proof
  • Medical practitioner's referral letter advising Hospitalization
  • Medical practitioner's prescription advising drugs/diagnostic tests/consultation
  • Original bills, receipts and Discharge card from the Hospital/Medical Practitioner
  • Original bills from pharmacy/Chemists
  • Original pathological/diagnostic tests reports/radiology reports and payment receipts
  • Indoor case papers
  • First information Report, final police report, if applicable
  • Post mortem report, if conducted
  • Any other document as required by the company to assess the claim


The claim form and additional documents are to be sent to us at the following address:
Religare Health Insurance Company Limited
Claims Department,
GYS Global, A-3, 4, 5, Sector-125, Noida,
Uttar Pradesh - 201 301

Step 3 : Claim Processing and Reimbursement

  • Our In-house medical team will review the case and documents submitted by you.
  • If your request for reimbursement of expenses is approved, you will be duly intimated by us.
  • In case of any information deficiency or further information requirements, you will be communicated instantly to ensure resolution of the same at the earliest.
  • If your request for claims is declined, you will be communicated the same along with valid reason(s) for rejection. However, if the insured/ insured's representative has further documents to enhance/substantiate his case for

claim, the same can also be sent to us; and if found rational, the case will be reopened for review of the documents and response, if any.

We will ensure that you are updated at all important stages of your claim process. To help us serve you better, please ensure the following-

The Pre-Authorization/Claim form is filled completely, sincerely and truly and all the required documents are submitted along with the form and in original, wherever specified. Retain a copy of the duly filled forms.

We will provide a reference id for all communication pertaining to claim request. Kindly quote that reference number for all communication related to the above.

 

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