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Documents required to make a claim at a hospital other than the network

I am currently being treated and may need to be hospitalized. The doctor I’m consulting suggested a hospital where cashless facilities aren’t available. What documents do I need to process my claim if I am treated at a hospital other than the network?

-Hold name on request

(Atul Deshpande’s answer is head-SBI General Insurance claims, digital, projects)

If you plan to be admitted to a network hospital, you should contact your insurance company in advance, or in the case of an emergency admission, within the suggested time to use the cashless facility. This gives the insured a hassle-free experience.

However, if you are planning or have been treated at a hospital other than the network, you will need to have the following documents handy:

A claim form formally filled out and signed by the insured. The form is usually available on the insurance company’s website or TPA.

Discharge Summary (original, pre- and post-hospital billing copy)

Hospital invoice (original)

For medicines purchased from outside, the original invoice must be accompanied by a prescription from your doctor

All original diagnostic reports.You can request a return when processing / paying your bill

If you are hospitalized due to an accident, you will need a medical statutory certificate (MLC) from the hospital.

All previous treatment papers related to the disease

Cancel a copy of the bank account transfer proposer’s check / passbook or fill out a NEFT form with the branch MICR code, branch IFSC code, account type and full account number to insured and banking authorities Formally signed by and sealed by the bank (required to process claims in all field forms)

A copy of the complaint notice (if any)

When the billed amount exceeds rupees. 1 Lakh, cKYC number / form and KYC document required (proof of identity, proof of address, copy of PAN card / form 60)

Many insurance companies accept electronic submission of documents to help expedite claim processing. We recommend that you check with your insurance company about this.

(Send a query and view at mintmoney@livemint.com)

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Documents required to make a claim at a hospital other than the network

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