Health insurance starting at just ₹243/month*
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Up to 40% Discount*
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Coverage Up to ₹5 Crores*
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10,000+ Network Hospitals*
Health Insurance Claims
Medical emergencies can happen anytime, and hospital bills can be very expensive. Doctor visits, medicines, tests and treatments cost a lot of money. During such difficult times, families shouldn't worry about arranging funds. That's exactly what health insurance claims are for – to help you get treatment without the stress of paying huge bills from your pocket.
A smooth health insurance claim process means you can access quality healthcare immediately without arranging large amounts of money. Whether it's a planned surgery or sudden hospitalisation, understanding the health insurance claims management system helps you use your policy benefits effectively when you need them most.
At IndusInd General Insurance (formerly Reliance General Insurance), we make claims simple and easy. Our cashless facility lets you receive treatment at network hospitals without paying up front. For emergencies at any hospital, our quick reimbursement process ensures you get your money back fast. We offer 24/7 claim support, easy online tracking to check your health insurance claim status and a dedicated team that processes claims quickly so you can focus entirely on getting better.
What is a Health Insurance Claim?
A health insurance claim is your request to us for covering medical expenses incurred during treatment. It is the formal process where you ask the insurer to pay for hospital bills, doctor consultations, medications and other healthcare costs covered under your policy. Think of it as activating your insurance protection when you need it most.
The claim makes sure that your policy benefits translate into actual financial support during hospitalisation or treatment. Whether planned surgery or emergency admission, filing a claim helps you receive the coverage you have been paying for throughout the year.
Types of Health Insurance Claims
Cashless Claims
Cashless claims let you receive treatment without paying upfront hospital bills. When you visit our network hospital, we directly settle the medical expenses with the healthcare facility. All you have to do is bring your health card and fill out the pre-authorisation form. This way, you don't need to arrange large amounts of cash. You can simply focus on getting better. The hospital talks to us directly, and we take care of all the payments for you.
Reimbursement Claims
Reimbursement claims work differently. First, you pay all the hospital bills from your own pocket. Then you send us the bills to get your money back. This is helpful when you visit hospitals outside our network or in sudden emergencies when cashless payment isn't possible. After discharge, collect all original bills, medical reports and receipts. You need to send them with the claim form, and we will review them and send the approved amount directly to your bank account.
How to File IndusInd Health Insurance Claims
Inform Immediately
Call us as soon as you're admitted to the hospital at +91 22 48903009 (Paid). For planned treatments, let us know 2 days early. For emergencies, inform within 24 hours.
Pick Network Hospital
Choose any hospital from our approved list. You can find these hospitals easily using our hospital locator tool below or by checking our IndusInd Insurance app anytime.
Show Your Card
Go to the hospital's insurance desk with your health card and ID proof. Fill out a simple form asking for treatment approval.
Get Approval
We'll check your request and send you a confirmation message quickly, usually within a few hours. You'll get updates on your phone and email.
Get Treatment
Relax and focus on getting better. Our TPA (Third Party Administrator) talks directly to the hospital and pays your covered medical bills. You don't need to worry about payments.
Tell Us First
Let us know about your hospital admission right away via phone. This helps us get ready to process your claim faster when you submit it.
Pay Hospital
Pay all your hospital bills, medicine costs, and test charges yourself. Make sure you collect proper bills with all details and keep the original payment receipts safe.
Gather Papers
Collect your discharge summary, all hospital bills, payment slips, test reports and doctor's prescriptions. Make sure everything is original with proper hospital stamps and signatures.
Send Documents
Fill out our claim form carefully with the correct information. Attach all your papers and send everything to us within one week through our website or visit our office.
Get Money Back
We'll check all your documents and verify everything. Once we approve your claim, we'll send the money straight to your bank account within 15 days.
Documents Required for Health Insurance Claims
Claim Form: Fill out and sign the claim form we provide. You can get it from our office or download it from our website easily.
ID & Policy Papers: Any government ID and a copy of your insurance policy showing your policy number, what's covered, and when your policy is valid.
Hospital Bills: Original detailed bills from the hospital showing room charges, doctor fees, medicine costs, tests, and all treatments you received during your stay.
Discharge Summary: The final report from your doctor explaining what illness you had, what treatment was given, how many days you stayed, and advice for recovery.
Medical Reports: All your test results, like blood tests, X-rays, scans, and any other reports that show what health problem you had.
Doctor's Prescriptions: Prescriptions written by your doctor for medicines, treatments, and follow-up care during and after your time in the hospital.
Payment Receipts: Original receipts proving you paid for treatments, including advance payments, final bills, pharmacy bills, and all other medical expenses.
Extra Documents: If you had an accident, bring the police FIR or the hospital's medico-legal certificate. For special cases, we may ask for additional papers.
Disclaimer: For the full list of claim documents, please refer to our policy documents or get in touch with our customer helpline.
How to Check Claim Status
Step
Enter Details
Enter your policy or claim number in the box at the top-right corner.
Step
View Status
Press the "Show My Claim Status & Upload Pending Documents" button.
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Check Updates
Check the status on if your claim is approved, being checked, or settled.
Step
Add Documents
If we need more documents, you can upload them right here on the same page.
Cashless vs Reimbursement Claims
Aspects | Cashless Claims | Reimbursement Claims |
|---|---|---|
Payment Method | We pay the hospital directly for you | You pay first, we return money later |
Hospital Network | Only our approved network hospitals | Any hospital you choose anywhere |
Advance Intimation | Tell us 2 days before planned treatment or within 24 hours for emergencies | Better to inform early, but you can tell us after treatment too |
Documentation | Show health card and fill form before treatment starts | Submit all bills and documents after you leave hospital |
Processing Time | Approved in few hours so treatment can begin | Money returned in 15 days after we check papers |
Out-of-Pocket Expense | You pay nothing or very little upfront | You must pay everything first from your pocket |
Convenience Level | Very easy, no money tension at all | Need to arrange money first, but can go anywhere |
Types of Hospitalisations Covered by IndusInd Health Insurance Claims
Emergency Hospitalisation
Emergency hospitalisation is when you require immediate medical attention due to sudden illness, accident or injury. For this, you need to inform the insurance company within 24 hours of admission to the hospital.
Planned Hospitalisation
Planned hospitalisation is when you already know about the medical procedure or treatment you are going to undergo. It is usually advisable for specific treatment or pre-planned surgery. If you plan to be hospitalised, you must inform the insurance company at least 48 hours before the planned date of admission.
How to Appeal a Rejected Health Insurance Claim?
Stage - 1
Call us at +91-22-4890-3009 or drop us an email on the below details:
Email Address: services@indusindinsurance.com
Stage - 2
If you are not satisfied with stage 1, contact our Nodal Officer.
Email Address: grievances@indusindinsurance.com
Stage - 3
For further objections, get in touch with our Head of Grievances.
Email Address: grievances@indusindinsurance.com
Stage - 4
If your issue remains unresolved, seek assistance from the Insurance Ombudsman.
Click here to find your nearest location.
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Common Reasons for Health Insurance Claim Rejection
Incomplete Documentation
Your claim gets rejected when you don't give us all the documents or if the papers are incorrect. Always send complete discharge papers, original bills, prescriptions, and test reports together.
Non-Disclosure of Medical History
If you hide your past health problems when buying insurance, your claim will be rejected later. Always tell us honestly about any diseases you had before.
Waiting Period Not Completed
Every policy has a waiting period before you can claim. If you file a claim too early, it gets rejected. Check your policy to know how long you must wait.
Treatment Not Included
Some treatments, like cosmetic surgery or unapproved experimental procedures, are not covered in your policy. Read your policy carefully to know what's included and what's not.
Policy Expired
When you don't pay your insurance payment on time, your insurance stops. If your insurance has stopped, we can't help with your claim. Pay before the last date to keep your insurance working.
Late Claim Intimation
Delaying claim intimation beyond the specified timelines causes rejection. For planned hospitalisation, inform 48 hours prior; for emergencies, notify within 24 hours of admission always.
Tips to Avoid Claim Rejection
Read Your Policy Carefully
Before going to the hospital, understand what your policy covers, what's not covered, waiting periods, and how to claim. When you know these details clearly, your claim won't face problems later on.
Provide Accurate Information
Tell us your complete medical history and true personal details when buying insurance and filing claims. Being honest means your claim won't get rejected later because of wrong information or hidden facts discovered during verification.
Keep Documents Organised
Put all your medical records, bills, prescriptions and policy documents in one safe place at home. When papers are organised properly, filing claims becomes easy and fast, with less chance of rejection for missing documents.
Intimate Claims Promptly
Tell us immediately when you go to the hospital – 2 days early for planned surgery or within 24 hours for emergencies. Quick information allows us to approve requests faster and avoids rejection due to late notification issues.
Use Our Network Hospitals
Go to our approved hospitals whenever you can for easy, cashless treatment. These hospitals know our process well, making everything smoother, quicker, and your claim approval happens without delays or hassles.
Follow Up Regularly
Keep checking your claim progress on our website, app, or by calling us. Regular checking helps you find out early if any papers are missing, so you can send them quickly and get your claim settled on time.
Key Takeaways
Medical emergencies happen suddenly, and hospital bills can be very expensive. Understanding the health insurance claim process is important because it helps you get the money you need quickly when facing a medical situation. Knowing how to file claims properly means you can actually use the insurance you have been paying for.
At IndusInd General Insurance (formerly Reliance General Insurance), we keep health insurance claims management simple and easy. Our cashless facility means you don't pay anything upfront at our 10,000+ network hospitals* across India. For treatment at any hospital, our reimbursement process returns your money within 15 days. You can file claims instantly using our IndusInd Insurance app from anywhere, anytime.
We approve claims quickly and only ask for the papers that are really needed, so you can focus on getting well without any worry. Just remember to inform us 48 hours before any planned treatment, or within 24 hours for emergency hospital stays. Keep all your hospital bills and medical documents together so your claim gets approved even faster.
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Disclaimer:
*T&C Apply. For more details on risk factors, terms conditions, brochure, and exclusions, please read the policy wording and CIS carefully before concluding a sale.
The total no. of customers insured data is for FY24 and has been picked up from the number of lives insured for Health, Personal Accident, Overseas Travel, Domestic Travel, Workmen Compensation and Crop Insurance, Weather LOB & Fire LOB provided by IRDAI count that is master policy count. Other than these LOBs, we have also provided data for the number of certificates issued.
Claim Settlement: This is the overall claim settlement ratio for FY 2023-24 without claim outstanding at the start of the financial year as per public disclosure of Reliance General Insurance Co. Ltd.
Premium: The premium mentioned is excluding taxes for single person aged between 5 years to 20 years with individual health policy for Sum Insured of ₹3 lakhs considering no adverse health conditions/pre-existing disease/medical conditions with waiting period of 3 years. For more details, please refer to the policy wordings. Premium used is 2,919/year converted into a month which gives us Rs.243/month (2,919/12).
Health Infinity UIN: The details mentioned above are for Reliance Health Infinity Insurance UIN: RELHLIP23120V042223
Health Gain UIN: The details mentioned above are for Reliance Health Gain Policy. Reliance Health Gain UIN: RELHLIP22229V032122
Health Super Top-Up UIN: The details mentioned above are for Reliance Health Super Top Up. UIN- RELHLIP21617V012021.
Heath Global UIN: Details mentioned above are for Reliance Health Global UIN: IRDAN103RP0001V01202324
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