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← All claims assistance

Support by insurance type

Health & personal accident claims

Health, hospital-cash and individual accident benefit enquiries.

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Find your policy type.

Open a section for relevant claim concerns and useful records. Your policy determines the cover; we confirm the assistance available after review.

Individual & family health

For claim concerns under individual health and family-floater policies, including hospitalisation, reimbursement and cashless requests. Maternity, OPD and pre/post-hospitalisation concerns can also be reviewed where those benefits are included in your policy.

Useful records

  • Policy schedule, full wording and insurer or TPA response
  • Claim form, discharge summary, bills, receipts and relevant reports
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Individual personal accident

For accidental-death or disablement benefit enquiries under an individual personal-accident policy. The accident records, selected benefits and insurer’s stated requirements guide the document review.

Useful records

  • Personal-accident policy, claim form and insurer correspondence
  • Relevant accident, medical, death or disability records, as applicable
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Critical illness & cancer

For benefit-payment concerns under critical-illness or cancer policies and applicable riders. A diagnosis must meet the policy’s defined conditions; these benefits differ from reimbursement of hospital bills.

Useful records

  • Policy or rider wording and the insurer’s stated reason
  • Diagnosis date, specialist records and relevant investigation reports
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Top-up & super top-up

For claims where the policy’s deductible or threshold affects payment. We bring together the relevant hospital bills and settlement records so the insurer’s calculation can be understood.

Useful records

  • Top-up policy schedule and deductible details
  • Relevant bills and base-policy or other payment records, where applicable
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Hospital cash

For fixed daily-benefit payment concerns under a hospital-cash policy or selected hospital-cash add-on. The hospitalisation dates and benefit conditions are important; this payment differs from reimbursement of hospital bills.

Useful records

  • Hospital-cash policy or add-on details and benefit schedule
  • Admission and discharge records, claim request and insurer response
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Claim concerns you can discuss

  • Cashless request concerns
  • Hospitalisation reimbursement
  • Pre- and post-hospitalisation claims, where covered
  • Maternity, OPD and other selected health benefits, where covered
  • Individual personal-accident and hospital-cash benefit enquiries
  • Deductions and rejected or delayed claims

Documents to keep ready

  • Policy wording and schedule
  • Discharge summary and relevant prescriptions or reports
  • Bills, payment receipts and insurer/TPA correspondence

The relevant documents and available assistance depend on the exact policy and circumstances. The team will confirm the scope after understanding your enquiry.

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©2018 by RohiniCLS.

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