New India Assurance Mediclaim Claim Procedure
New India Assurance Mediclaim Claim forms are used in claim settlement. New India Assurance Mediclaim Claim Procedure gives you information about how to claim New India Assurance Mediclaim Policies. You can know about Intimation of claim to the New India Assurance Company Limited/TPA (Third Party Administrator), New India Assurance Mediclaim Claim Procedure to avail Cashless facility, New India Assurance Mediclaim Claim Procedure for Reimbursement of claims and Documents required during claim settlement.
Notification of New India Assurance Mediclaim
The Insured person shall intimate the New India Assurance Company limited (if claim is processed by the company) or to TPA (if the claim is processed by TPA). Insured should intimate them in writing by E-Mail, Fax, Letter with all accurate and relevent information related to the claim including policy number, nature of treatment etc. within the time limit as prescribed.
Here all claims will be settled by specified TPA (Third Party Administrator) licensed by IRDA.
Notification of Claim | Information to TPA |
Planned Hospitalization | 48 hours before Hospitalization |
Emergency Hospitalization | 48 hours from the time of Hospitalization |
New India Assurance Mediclaim Claim Procedure for Cashless Claim
- Cashless facility in network hospitals shall be available if you have chosen ‘claim processing by TPA’.
- Insured person can take treatment in a network provider/PPN, subject to pre-authorization by TPA.
- For list of network hospitals please visit www.newindia.co.in
- Cashless request form will be available with the network provider/PPN and also with TPA. You should fill this form with complete information and submit to the TPA for pre-authorization.
- Upon getting cashless request form and other related medical information from the insured or network provider TPA shall issue pre-authorization letter to the network hospital after verification.
- At the discharge time, the insured has to sign the discharge papers after verifying.
- Insured has to pay for non-medical and inadmissible costs or expenses to the hospital at the discharge time.
- In case Insured is unable to provide the relevant medical details, TPA reserves the right to deny pre-authorization.
- In case of denial, insured may get the treatment as per treating doctor’s advice and submit the required claim documents to the TPA (Third Party administrator) for reimbursement of claims.
New India Assurance Mediclaim Claim Procedure for Reimbursement of Claims
- For reimbursement of claim, the Insured has to submit the required claim documents to the TPA (Third Party administrator) within the time limit as prescribed.
- Insured can obtain treatment as per treating doctor’s advice. During or before the treatment, Company will not pay the expenses incurred in treatment to the insured.
- Insured has to pay the expenses incurred in treatment and he should submit the bills and some other required documents to the TPA to get reimbursement of claims.
Documents Required during New India Assurance Mediclaim Claim Settlement
- Claim form with complete information.
- Bill, Discharge certificate and Receipt from the hospital.
- Cash Memos from hospital / chemists
- Receipt and Pathological test reports
- Surgeon’s certificate stating nature or plan of operation performed and diagnosis along with bills etc.
- Attending medical practitioner’s certificate regarding bill receipts and diagnosis etc.
- Certificate from attending Surgeon / Medical Practitioner that the patient is fully cured etc.
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