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Do You Have A Claim Request To Make, Or Already Have A Claim Registered With Us And Wish To Track Its Progress?
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Do you know what is CKYC? And why is it requested for during health claims processing?
Central KYC is essential for processing claims above ₹1 lakh. Watch here to understand more: https://youtu.be/pkP-0pIR2Go
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How to intimate/notify a claim?
You can initiate a claim using the “initiate claim” feature on the TATA AIG Insurance - Apps on Google Play Store or on the App Store or using self-service portal or or call our 24/7 customer support number 022 6489 8282 (or 1800 267 1955 for senior citizens).
Cashless Claim vs. Reimbursement Claim: Which is better?
A cashless claim is typically more convenient, as TATA AIG directly settles the hospital bill without requiring any upfront payments from you, allowing you to focus on recovery. Reimbursement claims require you to pay the bills first and then apply for reimbursement, which can take additional steps and processing time.
Where can I check the list of network hospitals?
The network hospital list is available on the TATA AIG Insurance - Apps on Google Play or on the App Store or self-service portal website. To find the list of our network hospital on our website Click here.
What is the difference between network and value provider network?
Value Provider Networks offer enhanced services and discounts within the network of TATA AIG hospitals. To find the list of our network hospital on our website Click here.
What are excluded providers?
Excluded providers are hospitals or healthcare providers not covered under your policy. Claims made with these providers will not be eligible. To find the list of excluded providers on our website Click here.
Where can I find the list of excluded providers?
Download the list from the TATA AIG website by visiting the ‘Downloads’ section and entering “excluded” in the search bar. To find the list of excluded providers on our website Click here.
Where can I view the list of Valued Provider Networks?
You can access the list on the on the TATA AIG Insurance - Apps on Google Play Store or on the App Store or by visiting website directly. To find the list of our valued provider on our website Click here.
What documents are required for a cashless facility?
Required documents include:
- Insurance card/policy copy
- Customer photo ID
- Address proof
- CKYC form (if the claim is over ₹1 lakh)
- Admission notes and previous medical records (optional for reference)
Can I avail of a cashless facility from a non-network hospital?
Yes, through our #GetCashless facility, you can use a cashless service at non-network hospitals in three simple steps:
- SMS “GetCashless
” to 7428192242 or call 022 6489 8282. - A claim expert will call you to gather hospital details.
- We’ll verify the hospital and issue an authorization letter.
How can I access the cashless health check-up option?
On the TATA AIG Mobile App, select “cashless health check-up,” choose your package, fill in details, and confirm availability. Our team will contact you to arrange the check-up. To download TATA AIG Insurance - Apps on Google Play or on the App Store.
What is Reimbursement?
Reimbursement refers to paying for medical expenses upfront and then submitting a claim for eligible costs according to policy terms.
Is there a time limit for submitting a claim after treatment?
Submit claim documents within 15 days of discharge or the completion of treatment.
What is Co-payment?
Co-payment is a cost-sharing mechanism where the insured pays a percentage of the claim amount. It does not reduce the Sum Insured.
What bank details are required for reimbursement claims?
Submit a cancelled cheque with the policyholder’s name, or provide a bank passbook or account statement with clear visibility of the name, account number, and IFSC code.
What documents are required for a health insurance claim?
To submit a health insurance claim, please ensure you have the following documents:
- Completed and signed claim form, to Download Claim form click here.
- Insurance card or a copy of the policy.
- Doctor’s medical certificate.
- Pathology reports (e.g., X-ray results).
- Hospital discharge card/certificate.
- Original hospital bills and receipts.
- Original pharmacy bills.
- Investigation reports, if applicable.
- FIR/MLC copy (for accidental claims).
- NEFT details for claim settlement.
- CKYC form (required if the claim amount exceeds ₹1 lakh).
How can I claim health check-up packages under my policy?
You can claim preventive health check-up packages according to your sum insured. To streamline the process, use the cashless health check-up option on the TATA AIG Mobile App, which removes the need for upfront payments or paperwork. To download TATA AIG Insurance - Apps on Google Play or on the App Store.
Can lab expenses be claimed under OPD Treatment Benefit?
Yes, lab or investigation expenses can be claimed under the preventive health check-up benefit, subject to eligibility. Other costs, such as consultation and pharmacy purchases, are covered under the OPD Treatment Benefit up to specified limits.
How do I make a claim if admitted to a non-network hospital?
For non-network hospitalizations, pay bills upfront and file a reimbursement claim. Alternatively, use our #GetCashless service by sending an SMS or calling our helpline.
Where do I download a claim form?
To Download the claim form Click here. You can also complete and submit the form via the app or website.
How do I download my policy wording?
Visit the “Downloads” section of our website, select your policy, and download the policy wordings. To view and download Click here.