Bajaj Allianz Health Insurance Claim Settlement

The claim settlement process for health insurance policies from Bajaj Allianz is simple and hassle-free. You can file a claim online from anywhere in the world and at any time in just 4 simple steps.There are two different kinds of insurance claims that you can file online depending on where you undergo treatment. In the case of medical treatment through network hospitals, you can file a cashless claim with Bajaj Allianz. And in case you choose non-network hospitals, you can file a reimbursement claim.

Overview

Customer care is an important part of running a business and Bajaj Allianz, with its customer-first approach, understands the importance of bringing the best to the table when it comes to customer satisfaction. The claim settlement process of Bajaj Allianz health insurance plans is painless and hassle-free. With a huge network of hospitals in its list of partnered healthcare centres, Bajaj Allianz General Insurance takes care of health insurance claims with easy reimbursement and cashless treatment at any network hospital in India. Moreover, with an impressive claim settlement ratio of 98%, the company highlights its commitment to serving its customers better.

A pioneer in cashless claim settlement, the Bajaj Allianz General Insurance works toward making this process better. With cashless treatments across the empanelled hospitals, you get treated for a particular illness without paying a single penny of the medical bills. With over 6,500 network hospitals of Bajaj Allianz Health Insurance in the country, this process becomes even easier.

Here’s how you can file a cashless claim:

1. Find the nearest Bajaj Allianz 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 Allianz cashless card while visiting the hospital.

4. Fill 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 Allianz-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
• First consultation letter from doctor
• Original hospital bills with detailed cost breakup
• Copy of invoice/stickers/barcode in case of implants
• KYC form

While cashless claims come with the ease of getting your treatments done without paying for the hospital bills out of pocket, you can also choose to get your treatment done at your cost and get the amount reimbursed later against your health insurance policy. 

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

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

2. Bajaj Allianz 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
• Completely 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

• You need to approach the network hospital along with your policy details.

• The network hospital verifies the details provided by you and sends a pre-authorisation form to the insurance provider.

• The insurance provider verifies the pre-authorisation request and informs the network hospital about your policy's coverage. If needed, the insurance provider may send a query letter to the network hospital requesting more details. The network hospital needs to respond to this query with the information requested.

• Once the network hospital receives approval from the insurance provider, the treatment begins. Upon discharge from the network hospital, the final bill, along with the discharge papers, are sent to the insurance provider. The insurance provider will settle the final amount with the network hospital after deducting co-payment (if applicable) and other consumable expenses.

• Should the pre-authorisation request get rejected; you will have to bear all treatment expenses which can be reimbursed later.

• Once discharged from hospital, you need to collect all original documents and bills and submit them to the insurance provider.

• The insurance provider initiates scrutiny of all claim-related documents. If additional documents are needed, you will be intimated about the additional documents required.

• Once all necessary documents are received, the insurance provider approves the claim.

• Payment will be released to you based on what is admissible under the insurance policy.

1.Company Cancellation

The insurance provider may cancel your insurance policy providing a written notice 15 days prior to cancellation date. If no claim has been made, a refund of the premium for the unexpired policy period shall be provided on a pro-rata basis.

Your insurance policy will be cancelled for reasons such as non-disclosure of material facts, misrepresentation, fraud and non-cooperation.

2.Customer Cancellation

As a customer, you may cancel your insurance policy by providing a written notice 15 days prior to cancellation date. If you've made no claims, the insurer will refund short-term rates for the unexpired policy period as per the rates detailed below.

Cashless Claims

• Cashless Claims Request Form

   

Claim Reimbursement

• Reimbursement Form

   

Other Health Insurance Related Claims

• Self Declaration of KYC Document Submission - For Individual Partner

• Non-Medical Expenses List of Exclusionsr

• Personal Accident Claim Form

   

Links for Claim Settlement Forms

• Cashless Claims Request Form

• Reimbursement Form

• Self Declaration of KYC Document Submission - For Individual Partner

• Personal Accident Claim Form

• Non-Medical Expenses List of Exclusions

   

List of Network Hospitals

• List of Network Hospitals

   

Brochure

• Health Guard Brochure
  

• Extra Care Plus Brochure
  

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 Allianz health insurance claim status:

1. Visit the official Bajaj Allianz 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 Allianz 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 Allianz 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 Allianz 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.

Health Insurance Plans Available at Bajaj Markets