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Which Documents Will I Require To Seek Mediclaim Reimbursement-


Have you bought mediclaim insurance.If yes the you are on right path.But things won’t end here.

If any claim arises then companies will demand different documents and if we know in advance then we will able to take care about it.

Few months back we have a post of Cashless mediclaim.Post about Cashless Mediclaim can be viewed here :

Cashless Mediclaim – How To Avail Benefits of cashless Mediclaim 

Sometimes we may not able to avail benefit of Cashless mediclaim and we need to seek reimbursement from insurance company.

Following documents are generally required to claim Reimbursement :

Duly Filled Claim Form – By insured as well by treating doctor indicating date & time of admission,Reg No of Hospital,No of beds .

Detailed Field Visit report – from doctors appointed by insurance company.

Copy of health card / Identity card issued by insurance company.

Original discharge summary – Discharge summary with details of complaints,treatment availed.

All investigation reports – Blood reports,X-Ray,Sonography,MRI & other related investigation report.

Final Hospital Bills – Final hospital bills with detailed break up like pharmacy bill and break up as per interim sections of the hospital.

Receipt of payments made to hospital.

All Pharmacy bills need to be supported by Doctors prescription.

In case of Accidental case – copy of FIR [First Information Report] /  MLC [medico Legal Certificate] / Self declaration indicating the the circumstances / nature of the accident & injuries.

Invoice of different surgicals used .E.g Details of Lens used for cataract case or Details of  Stent used for angioplasty.

In case of maternity claims – obstetric status of the claimant from treating Gynecologist.

Age Proof if there is discrepancy in age mentioned in policy & in hospital document.

If claim is within waiting period [mostly 30 days] or other exclusions are applicable then details of policy with other companies held by insurer to avail portability feature.

If hospital is Non-Network hospital then you may require additional documents like :

– Registration Certificate of Hospital from muncipal authorities.

Detailed field visit to be conducted by company for details like Infrastructure available,Number of beds,ICU facility,Qualifications of  doctors from whom treatment is availed.

This is the list of general documents required to seek reimbursement from insurance company.These documents are well scrutinized by company before claim is settled.If we are aware about it then we can avoid inconvenience..isn’t it?


Category: Insurance

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