The claim is a formal request made by the policyholder to the insurance provider to seek compensation for the medical expenses incurred due to treatment. In the constantly evolving world of insurance, filling claims accurately is the key to maintaining financial stability. Bajaj Allianz has designed a simple process to do so, so that, you can easily submit your claims in a matter of few steps.
Bajaj Allianz stands at the forefront of providing comprehensive and affordable healthcare. The company has a Claim Settlement Ratio of 96.59%, which translates to the readiness of the company to settle the claims.
Health Insurance Companies: Policy and Claim Process
The claim process can be submitted in two ways, based on the payment we make in the hospital following the treatment. The two types are as follows :
Cashless Claims: In cashless claims, the policyholder receives the treatment and does not pay upfront for the covered expenses. The insurance provider directly settles the medical bills with the hospital.
Reimbursement Claims: Reimbursement claims give policyholders the flexibility of getting treated at any of the healthcare facility and later get the medical costs reimbursed from the insurance provider.
How To Claim Bajaj Allianz Health Insurance: Cashless Claims
In the case of cashless claims, the policyholder must initiate the claim by informing the company about the claim. It can be done by either TPA (Third Party Administrator) or by directly contacting Bajaj Allianz Health Administration Team- (HAT). TPA act as a mediator between the policyholder and the company. TPA will verify the policy coverage and help to facilitate the pre-authorization of the cashless treatment. Here are a few actions to raise a cashless claim:
Step 1: Inform the Company and Contact the TPA
Upon admission to a network hospital, inform the company about the claim. Contact the TPA for claim intimation, you can show your 'Health Insurance Card' to the TPA for policy details. You can find the list of Bajaj Allianz TPA, on the official website of the company.
Step 2: Document Submission
The TPA will coordinate with the hospital and collect all the documents along with the duly filled pre-authorization form. Then the TPA desk of the hospital contacts BAGIC (Bajaj Allianz General Insurance Company Limited) and submits all details and the form to the company.
Step 3: Verification Process
BAGIC team will verify all the details about the claim and notify the policyholder after verification, whether the claim is accepted or rejected. Bajaj Allianz Health Insurance Company asserts that it only takes 60 minutes for the verification.
More Details Asked By The Company
Sometimes the company asks for more details. Here are the steps taken by the healthcare provider:
The company will send a letter of query to the hospital asking for more documents or details.
Once the company receives all the additional documents they will send the authorization letter within 7 days.
After receiving the authorization letter the, network hospital will notify the patient.
Step 4: Settlement
Finally, after completing all the treatment procedures the bill will be settled with the hospital.
How To Claim Bajaj Allinaz Health Insurance: Reimbursement Claims
Reimbursement process gives the liberty to the policyholder, to choose the hospital of his choice. Let us go through the procedure:
Step 1: After completing treatment procedures and paying the bill at the hospital, collect all documents from the hospital.
Step 2: Submit documents along with the duly filled claim form to BAGIC-HAT. (Bajaj Allianz General Insurance Company - Health Administration Team)
More Details Asked By The Company
Advance Notice: If any documents or details are missing, Bajaj Health Insurance Company will send advance notice and give time to the policyholder to send the details.
Document Submission: After receiving the required documents and clarification on additional detail the company will start the claim processing.
Step 3: The company will settle the compensation amount with ECS within 10 days and will notify the customer about the same.
Note:
If in case, the company doesn't receive the pending document, they will send 3 reminders within 10 days apart from the initial notice.
If the policyholder is unable to provide the missing document within 30 days, from the initial notice, the claim will be considered closed. The company will notify the policyholder of the closure.
Documents Required For Filing a Bajaj Health Insurance Claim
Here is the list of documents required to file a claim:
Original discharge summary documents
Original hospital bill with cost break -up
Original paid receipt
All lab and test reports
Copy of invoice/stickers/barcode in case of implants
First consultation letter from the doctor
KYC Form
Completely filled and signed NEFT form by the policyholder
Conclusion
Bajaj Allianz is committed to providing accessible and reliable healthcare solutions. Designing a comprehensive plan is not enough, settlement of the claim is also crucial as it is the ultimate goal of the lifecycle of a policy. An insurance company is regarded as a trustworthy partner when it provides good healthcare plans along with a robust claim process. Bajaj Health Insurance is one of them as the company has an efficient mechanism to settle the claim. Backed by technology and trained staff, their claim settlement process is fast and seamless.
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Invested in a senior citizen health insurance with Bajaj Allianz for my parents and the coverage benefits are very helpful
Riya Chatterjee
Pune
October 9, 2023
Recently purchased a senior citizen plan from Bajaj Allianz and it provided my parents with wellness benefits and annual health check-ups that are useful for me as I stay away from my family.
Rishabh Singh
Chandigarh
October 9, 2023
Quick and efficient response from customer care of Bajaj Allianz when it comes to claim settlement queries.
Priyanka Kumari
Guwahati
October 9, 2023
Provides different options in health insurance and offers unique benefits. I purchased a maternity plan from Bajaj 2 years ago and now I am planning to start a family. Bajaj Allianz has been ve...
Smita Patil
Bengaluru
May 1, 2023
I have availed health insurance services from PolicyX in the year 2021 and I must say that they are reliable and have supported me with claim settlement without any delay.
Pawan
Delhi
June 6, 2022
Trust me, friends, Bajja is one of the best insurance companies in India. It offers good health insurance plans and its claim service is superb. I am very impressed by the work done by Bajaj Al...
Himanshi Nalwa
Pune
May 26, 2022
My claim was settled in no time... I went to a non-network hospital and Bajaj Allianz reimburse my claim within 2 days
Priya Singhania
Guwahati
May 26, 2022
I took the health insurance plan for my family. Bajaj Allianz is a nice company. Go for it. Thanks to Policyx.com, they helped me a lot.
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