Bajaj General Health Insurance Claim Settlement

Navigating Bajaj General Health Insurance's claim settlement process is straightforward. Whether opting for cashless treatment at network hospitals or seeking reimbursement at non-network facilities, the process is quick and simple.

Policyholders can receive medical treatment at network hospitals without making direct payments. Instead, the insurance provider settles the bills directly with the hospital, simplifying and expediting the reimbursement process for the insured individual. With over 8,600 network hospitals of Bajaj General Health Insurance in the country, this process becomes even easier.

Here’s how you can file a cashless claim:

1. Find the nearest Bajaj General network hospital in your city where you want to get treated.

2. Inform the insurer regarding your hospitalisation.

3. Carry your identity proof and your Bajaj General cashless card while visiting the hospital.

4. Fill out the pre-authorisation request form available at the hospital desk and submit it to the hospital.

5. The hospital will then send the pre-authorisation request form to Bajaj General-HAT (Pune) for verification.

6. The insurer will review your application and convey the claim decision to the hospital.

7. On approval, the hospital will begin the cashless treatment.

• Duly signed hospitalisation claim form

• Original discharge summary document

• All lab and test reports

• Consultation letter from doctor (s)

• Original hospital bills with detailed cost breakup

• Copy of invoice/stickers/barcode in case of implants

• KYC form

Reimbursement claims involve the policyholder initially covering the medical costs. Afterwards, the insured individual submits the relevant documents and receipts to the insurance company for review and approval. Once approved, the insurer reimburses the policyholder for the eligible expenses, up to the agreed-upon coverage limit. Reimbursement claims provide flexibility in choosing healthcare providers outside the insurer's network.

These are the steps you will need to follow for the Bajaj General health insurance claim process:

1. Submit all original hospitalisation-related documents to the insurer.

2. Bajaj General Insurance will then complete the verification, for which other documents may be required.

3. The insurer then takes the process forward.

4. Once your claim is approved, the customary verification is initiated, post which the team releases the payment.

• Duly filled hospitalisation claim form

• Filled and signed NEFT form by the policyholder/proposer

• Original payment receipts and discharge summary document

• Copy of the invoice in case of implants

• Original hospital bills with detailed cost breakup

• All Lab and test reports

• Doctor’s first consultation letter

• KYC documents

Need further assistance? Reach out on the Toll-Free Number: 1800-209-5858 to connect with an insurance expert.

Here are the steps you can follow to check your Bajaj General health insurance claim status:

1. Visit the official Bajaj General Insurance website.

2. On the website, visit the ‘Support’ section.

3. Click on ‘Policy Tracker’.

4. Submit all the details and documents required.

5. Your online Bajaj General health insurance claim status will be displayed on the screen.

In case you want to check the status of your claim offline, you can contact the Bajaj General customer care team or visit their office in person.

With a health insurance claim settlement ratio of 98% and the option for lifelong insurance renewals, Bajaj General can be an excellent choice when buying health insurance.

Apart from understanding the process, it is also very important to note why your claims on your health insurance policy may get rejected. This way, you can prevent the rejection of your claim and make full use of your insurance coverage. Here are a few reasons why your claims may get rejected:

• Cost Exceeds Sum Insured

In case the treatment cost exceeds the sum insured amount you are entitled to, your claims may get rejected.

• Ignoring Exclusions

In case the claim is made for a treatment that is not covered under the plan, your claim request is rejected.

• Invalid Claim

If any incorrect or false information is provided during claim intimation, the claim is held invalid and is rejected.

• Inactive Policy

If you file a claim after your policy has lapsed, the claims stand null. This further reinstates the importance of renewing your health insurance on time.

• Waiting Period

In case you file a claim for the expenses incurred for the treatment of a disease within the waiting period, your claim could be denied.

At Bajaj Markets

You can get in touch with the Bajaj Markets team, should you need any help with your Bajaj General health insurance plan:

• You can call us on 020-66399444. Our executive will be at your service from Monday to Saturday - 10 am to 6 pm.

• You can write to us at insuranceconnect@bajajfinservmarkets.in. 

• You can also login to our Customer Portal at https://www.bajajfinservmarkets.in/cust/#/. 

• Download the Bajaj Markets App, so you can easily manage your account and track your applications - anytime, anywhere!

At Bajaj General Insurance

Here’s how you can connect with the Bajaj General Health Insurance customer care in case you need any assistance regarding the product:

• Contact the executives at the call centre on 1800 209 5858 (main toll-free number) or their dedicated health toll-free number 1800 103 2529.

• Send an email to health.admin@bajajallianz.co.in. 

• Contact the customer care representative at any Bajaj General Insurance branch.

• Visit the website- https://general.bajajallianz.com/BagicHCM/cstprtl/getCustDtls.do. 

• Download the Caringly Yours App on the App Store/Play Store.