TATA AIG Health Insurance Claim Process

Raising a claim can be a tedious task, so to make the process effortless insurance companies design user-friendly platforms such as websites and mobile applications. In terms of claim filling procedure, TATA AIG Health Insurance has crafted a hassle-free process to raise a claim. The claim settlement ratio of the company is 93.55 %(for 3 months), which gives us a clear indication that the process of filling and settling the claim with TATA AIG is very easy and seamless. Let us discuss all TATA AIG health insurance claim procedures through this article.

Health Insurance Companies: Policy and Claim Process

Claim Filing Process Offered By TATA AIG Health Insurance

The company's claims are classified into two categories, based on the settlement and payment process, lets us examine each type one by one:

1. Cashless Claims:

This type of claim enables the policyholder to avail of the treatment without paying for the medical expenses upfront and then the insurance company will settle down the bill directly with the hospital.

Cashless Claims can be divided into two categories based on the situation of hospitalization and they are:

Planned Hospitalization:

• Inform the Company: In this process, the policyholder has to inform the insurance company, 5 days before the hospitalization.
• Wait For Confirmation: The company will issue a confirmation letter, which will be valid for 7 days from the date of issue.
• Admission Procedure: On the day of admission to the hospital, the policyholder has to submit the health card and confirmation letter to the hospital. After submission, the treatment will start.

Emergency Hospitalization:

• Inform the Insurer: The policyholder must inform the company within 24 hours of hospitalization.
• Required Document: Then, submit all the necessary documents, such as insurance card, policy copy, Cust Id proof with photo, address proof, and duly filled and signed CKYC form( If the amount is more than 1L).

2. Reimbursement Claims:

Reimbursement claims let the insured recieve medical care outside of the network hospitals of the insurance company. The policyholder pays the bill upfront and later requests for a reimbursement from the insurer. Reimbursement claims can be filed for 21 days after the hospitalization along with the submition of all the necessary details.

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How to Claim TATA AIG Health Insurance: Cashless Claims

If all the paperwork is aligned, cashless claims are a very straightforward process that goes quickly. Let's see the steps :

Step 1: Hospitals Help Desk Staff or TPA fills out the cashless claim request and submits it to the insurance company. TPA coordinates with the hospital to complete all the paperwork easily. The TPA also helps the policyholder to fill out the 'Pre-Authorization' form.

Step 2: After reviewing all the documents and pre-authorization forms, the company issues an 'Authorization Letter' to the hospital. And the company will complete the rest of the steps of settling the claim.

How to Claim TATA AIG Health Insurance: Reimbursement Claim

Follow these steps for a smooth reimbursement claim filing process:

• Verify Details: Before signing the final bill, please make sure that all the details are accurate and complete. It is better if the policyholder does not make any delay in the process.
• Collect the Documents: Collect all the necessary documents before leaving the hospital.
• Document Follow-Up: Submit the documents to the Third Party Administrator(TPA), assigned by the company or by the hospital authority. Your part of the work is finished here.

Later, the company will verify the documents and will send the amount to your bank account.

Points to keep In Mind:

• Submit all the documents to the TPA within 21 days of discharge.
• The company may assign its TPA, if not in contact with the hospital's TPA, authorized by the hospital administration.
• In the process of claim rejection, contact the TPA or customer care of the company for assistance.
• You can download the claim form from the official website of the company.

Documents Required For Reimbursement Claims:

There are many additional documents that may be asked by the company for better verification of the claim. Here is the list for the document:

Conclusion:

Filing the claims is extremely easy TATA AIG. Policyholders can choose between cashless or reimbursement claims depending on their convenience. Cashless claims are settled directly with the hospital whereas reimbursement claims provide the customer flexibility in choosing the health care facility of their choice. The company's customer services are readily available to help the policyholders in case of any confusion. You can find the details of customer care services on their official website.