Claims Form Guidelines

Complete guide to filling and submitting your health insurance claims accurately.

Required Documents

Ensure you have all necessary documents ready before submitting your claim.

Basic Documents

  • Completed claims form with all sections filled
  • Original hospital bills with bill numbers
  • Hospital discharge summary
  • All investigation reports
  • Original pharmacy bills with prescriptions

Additional Documents

  • Pre-hospitalization medical records
  • Post-hospitalization follow-up records
  • Doctor's consultation notes
  • Previous treatment records (if applicable)

Supporting Documents

  • Government issued photo ID proof
  • Copy of insurance card/policy details
  • Bank account details for reimbursement
  • NEFT mandate form (for direct transfer)

Important Note

All documents must be original or self-attested copies. Ensure all bills and reports are legible and include the hospital's registration number.

Form Filling Instructions

Follow these section-wise guidelines to ensure accurate form completion.

Personal Information

  • Use BLOCK LETTERS only
  • Provide complete name as per policy
  • Include valid contact information
  • Mention policy number correctly

Hospital Details

  • Enter complete hospital name and address
  • Include hospital registration number
  • Specify admission and discharge dates
  • Mention type of admission (Emergency/Planned)

Medical Information

  • Describe illness/injury in detail
  • List all procedures performed
  • Include ICD codes if available
  • Mention pre-existing conditions

Payment Details

  • Provide accurate bank information
  • Double-check account number
  • Include IFSC code
  • Attach cancelled cheque

Pro Tips

  • • Keep a photocopy of all submitted documents
  • • Use blue ink for filling the form
  • • Avoid overwriting and use of whitener
  • • Get all corrections authenticated by the treating doctor

Common Mistakes to Avoid

Learn from common errors to ensure smooth claims processing.

Incomplete Information

Missing or partial details in crucial fields like policy number, contact information, or hospital details.

Solution:

Double-check all fields before submission and ensure no section is left blank.

Missing Documents

Not including all required medical reports, bills, or supporting documents.

Solution:

Use the document checklist to verify all necessary paperwork is attached.

Incorrect Bank Details

Wrong account number or IFSC code leading to payment delays.

Solution:

Verify bank details multiple times and attach a cancelled cheque.

Delayed Submission

Submitting claims after the stipulated time period.

Solution:

Submit claims within 30 days of discharge or as specified in your policy.

Illegible Handwriting

Unclear or difficult to read handwriting causing processing delays.

Solution:

Use BLOCK LETTERS and write clearly in blue ink.

Unsigned Forms

Missing signatures on declaration or authorization sections.

Solution:

Check all signature fields and ensure they are properly signed.