Health insurance claims decoded
Aug 7, 2010

Your Detailed Guide to Health Insurance Claims

Health Insurance is an insurance product that covers your medical expenses in case you need to use health care services. Your medical costs can be covered either via cashless claims settlement or via reimbursement of the claim amount. You can avail the cashless health insurance claim settlement facility if you are admitted to a network hospital. If you are admitted to a non-network hospital, then you need to settle the hospital bills yourself and submit the hospitalization documents along with the claim form for the reimbursement of the hospitalization expenses. Documents Required: The documents required for quick and worry-free processing of your claim are listed below:
  • A photocopy of your previous policy details prior to taking your Health Guard policy from Bajaj Allianz (if applicable).
  • A photocopy of your present policy document with Bajaj Allianz.
  • First prescription from the doctor.
  • The health insurance claim form duly signed by you or your family member.
  • The hospital discharge card.
  • The hospital bill giving detailed break up of all expense heads mentioned in the bill. For e.g., if INR 1,000 has been charged towards medicines in the bill, please ensure that the names of the medicines, the unit price and the quantity used are mentioned. Similarly, if INR 2,000 has been charged towards laboratory investigations, please ensure that the names of the investigations, the number of times each investigation has been performed and the rate is mentioned. In this way clear break ups have to be mentioned for OT charges, doctor’s consultation and visit charges, OT consumables, transfusions, room rent, etc.
  • The money receipt duly signed with a revenue stamp.
  • All original laboratory and diagnostic test reports. For e.g., X-Ray, E.C.G, USG, MRI scan, haemogram etc. (Please note that you do not have to enclose the films or plates, a printed report for each investigation is sufficient.)
  • If you have purchased medicines in cash, and if this has not been reflected in the hospital bill, please enclose a prescription from the doctor and the supporting medicine bill from the chemist.
  • If you have paid cash for diagnostic or radiology tests and it has not been reflected in the hospital bill, please enclose the prescription from the doctor advising the tests, the actual test reports and the bill from the diagnostic center for the tests.
  • In case of a cataract operation, please enclose the IOL sticker.
For pre and post hospitalization expenses you would be required to submit the following documents:
  • Medicines: Please provide the doctor’s prescription advising medicines and the relevant chemist’s bills.
  • Doctor’s Consultation Charges: Please provide the doctor’s prescription and the doctor’s bill and receipt.
  • Diagnostic Tests: Please provide the doctor’s prescription advising tests, the actual test reports and the bill and receipt from the diagnostic center.
Important: Please ensure that you only submit the original documents. Duplicates or photocopies are usually not accepted by the insurance companies. Non-claimable Items in Hospital Bill: There are a few items in your hospital bill for which you might have to bear the expense on your own. These generally include:
  • Service charges, administration charges, surcharge, establishment cost, registration charges
  • All non-medical expenses
  • Private nurse expenses
  • Telephone calls
  • Laundry charge etc.
Learn more about our health insurance policies to get maximum coverage for any kind of medical emergency.

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  • Amit Joshi - June 27, 2012 at 1:04 am

    Dear Sir/Madam
    I want to take the Health guard Insurance for my parents whose age are 61 (father) and 52(mother). I want to know the list of illness/operations COVERED UNDER THE POLICY. And also would like to know the yearly premium for the same.

    • BJAZsupport - June 27, 2012 at 5:23 pm

      Dear Mr. Joshi,

      Thank you for contacting us. The concerned team will get in touch with on your id to assist you in buying health insurance.

      We look forward to serve you.
      Best Regards,
      Help & Support Team

  • Swetha - June 25, 2012 at 1:54 pm

    Claim no: OC-13-1002-6001-0000530
    Need a reimbursement please guide how to go about it IP NO:18505161,where do i download the form?

    • BJAZsupport - June 25, 2012 at 6:55 pm

      Dear Ms. Swetha,

      Thank you for writing to us. We shall mail across the required details on your id for your reference.

      Request you to go through the same and let us know in case of any query.
      Best Regards,
      Help & Support Team

  • JASWINDER - May 23, 2012 at 8:37 pm

    POLICY NUMBER,OG-12-1701-8416-00000138,I NEED TO INTIMATE THAT I M HOSPITALIZED,KINDLY LET ME KNOW Y U PEOPLE HAVE LISTED NUMBERS WHEN THERE IS ABSALOUTELY NO RESPONSE ON ANY OF THE NUMBERS….MY NUMBER IS 998******* PLEASE ASK SOMEONE TO CONTACT ME AT THE EARLIEST..THANK U

    • BJAZsupport - May 24, 2012 at 6:10 pm

      Dear Jaswinder,

      We regret the inconvenience caused to you. Our team will get in touch with you shortly.
      Best Regards,
      Help & Support Team

  • SUSHIL KUMAR SINGH - May 17, 2012 at 7:35 am

    Hi,

    Policy Number: OG-13-2403-8409-00000002

    For the above mentioned policy number, I need to initiate the process for health insurance claim. Recently i am having back problem & also problem in my Ear (for which i need to consult an ENT specialist).I have not yet consulted any doctor,however would do the same at earliest.
    Please let me know if I need to do anything else for this as i am to undergo treatment for the same at best possible time.

    Kindly, brief me the process and other details on my mail ID(mentioned in policy details or above). I Tried to contact on Toll Free nos but there was no response from other side.

    Regards,
    sushil kumar singh

    • BJAZsupport - May 17, 2012 at 6:49 pm

      Dear Mr. Singh,

      Thank you for writing to us. We have mailed across the required details on your id for your reference.

      Request you to go through the same and let us know in case of any query.
      Best Regards,
      Help & Support Team

  • anil - April 19, 2012 at 3:18 pm

    how do i intimate my hospitalization ?

    • BJAZsupport - April 20, 2012 at 7:02 pm

      Dear Mr. Anil,

      Thank you for writing to us. You can contact our nearest branch office, which can be located at https://apps.bajajallianz.com/gmlocator/

      Alternately you can also call us on our helpline numbers 1800-233-3355 or 020-66495000.
      Best Regards,
      Help & Support Team

  • LUCY RODRIGUES - April 3, 2012 at 2:57 pm

    WOULD LIKE TO HAVE A LIST OF ILLNESSES/OPERATIONS COVERED UNDER THE POLICY.

    IS DENTAL COVERED.

    LUCY

    • BJAZsupport - April 3, 2012 at 5:48 pm

      Dear Lucy,

      Thank you for writing to us. Request you to mail across your policy number and contact details.

      This will enable us to assist you better.
      Best Regards,
      Help & Support Team

  • Ashish - February 25, 2012 at 5:58 pm

    Hi,

    Policy Number: OG-12-9906-8416-00000005

    For the above mentioned policy number, I need to initiate the process for health insurance claim. Also, let me know if I need to do anything else for this as am undergoing surgical treatment.

    Kindly, brief me the process and other details on my mail ID(mentioned in policy details or above)

    Kind Regards,
    Ashish Anand

    • BJAZsupport - February 27, 2012 at 7:29 pm

      Dear Mr. Ashish,

      Thank you for writing to us. We shall send across a mail on your id for your reference.

      Request you to go through the same and let us know in case of any query.
      Best Regards,
      Help & Support Team

  • Ravi Dhankani - January 12, 2012 at 10:37 am

    Hi,

    I have a family floater health insurance policy no. OG-11-2202-6001-00000693

    My wife recently was taken to emergency ward for a severe back pain/injury. She was not admitted but X-ray and MRI scans told a L4-L5 compression , the doctor ordered complete bed rest.

    I hope emergencies or such accidents are covered in my policy. I have intimated a claim (#14902933) and will send documents soon.

    thanks
    Ravi

    • BJAZsupport - January 12, 2012 at 7:33 pm

      Dear Mr. Dhankani,

      Thank you for contacting us. We have sent across a mail on your id for your reference.

      Request you to go through the same and let us know in case of any query.
      Best Regards,
      Help & Support Team

  • PRABIR KUMAR SINHA - October 29, 2011 at 4:24 pm

    Dear Sirs,
    I have a Health Guard cover with you (OG-12-2401-8403-00000002) for me and my family members, which expires on 31/03/12.
    Recently,I Had done my Phaco Treatment from Disha Hospitals’ In Kolkata.
    As per Your Requirement, i have submitted my health insurance claim-with all relevant documents to your H.O.. in Pune.
    My claim reference number is 346970.Also the reference number of ‘system generated’ response to acknowledge receipt of my document is IN-1002-0420814.
    If You please settle my claim at the earliest, i would be highly obliged.

    Pl. reply to my mail ID.

    Thanks and Regards

    Prabir Kumar Sinha
    09874419813

    • BJAZsupport - October 31, 2011 at 6:33 pm

      Dear Mr. Sinha,

      Thank you for writing to us. We have forwarded your query to the concerned team.

      They shall look into the same and get in touch with you shortly.
      Best Regards,
      Help & Support Team

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