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Exhaustive Guide To Claim Intimation In Group Health Insurance

Exhaustive guide to claim intimation 2

Claim intimation clause in health insurance policies is a mandatory clause. This clause refers to the obligation of the policyholder to formally inform the insurance company (or their third party administrator) about a potential claim under the policy

This clause typically puts timelines for intimating the insurer. The imitation can be done via any mode of communication. It is advisable that you keep a record of this communication such that in cases where there may be a difference of opinion on having met this requirement, you can share it with the insurer. 

In case of hospitalisation, either as an emergency case or as a reimbursement case, this clause is equally applicable. 

In emergency cases this needs to be done within 24 hours of getting admitted to the hospital.

In planned cases, this needs to be done 48 hours prior to hospitalisation.

Why is intimation required?

Claim intimation is required mostly by the insurers for two main reasons:

  • To account for a potential payout to be made under the policy
  • To investigate a claim if the insurer feels that any direct or indirect mechanism needs to be activated to adjudicate and verify on the genuineness of the claim

Where to file my health insurance intimation?

You can file for intimation in the following ways:

  1. Send an email to the insurer
  2. Call the insurer on their general helpline
  3. Many insurers have a form on their website to facilitate claim intimation

Claim Intimation under Health Insurance Policy

Often policyholders are at a loss to access information with the relevant details on where to intimate and how to intimate. 

This article provides all contact details of all TPA’s and Insurers along with their email id’s and phone numbers to initiate claim intimation. Once the intimation has been done, kindly keep the interaction details handy. Often you may be allocated a transaction Id number which will confirm the receipt of your intimation.

Please note the following indicative list of insurers and TPA’s for claim intimation:

Sr. No.InsurerEmail IdPhone NoOnline Intimation LinkOnline claim Submission
1Acko General Insurance Ltd.health@acko.com1800-266-2256ACKO Mobile ApplicationACKO Mobile Application
2Aditya Birla Health Insurance Co. Ltd.care.healthinsurance@adityabirlacapital.com1800-270-700https://www.adityabirlacapital.com/healthinsurance/newwebsite/claim/reimbursement-claimabhicl.customerdocs@adityabirlacapital.com
3Bajaj Allianz General Insurance Co. Ltdbagichelp@bajajallianz.co.in1800-209-5858https://www.bajajallianz.com/claims/health-insurance/claim-process.htmlCaringly Yours Mobile App
4Cholamandalam MS General Insurance Co. Ltd.customercare@cholams.murugappa.com1800-208-5544https://claimscustomerportal.cholainsurance.com/intimate-claimhttps://claimscustomerportal.cholainsurance.com/reimbursement-claim
5Future Generali India Insurance Co. Ltd.fgh@futuregenerali.in1800 103 8889https://general.futuregenerali.in/health-claim-intimationNot Available
6Go Digit General Insurance Ltdhealthclaims@godigit.com1800-258-4242https://www.godigit.com/health-insurance/file-a-claimhttps://www.godigit.com/health-insurance/file-a-claim
7HDFC ERGO General Insurance Co.Ltd.care@hdfcergo.com022-6234 6234https://customersupport.hdfcergo.com/customer-care/claim-registration.html?https://customersupport.hdfcergo.com/customer-care/claim-registration.html?
8ICICI LOMBARD General Insurance Co. Ltd.ihealthcare@icicilombard.com18002666IL Take Care Mobile ApplicationIL Take Care Mobile Application
9Liberty General Insurance Ltd.health360@libertyinsurance.in1800-266-5844Not Availablehttp://bit.ly/myonlineclaim
10Max Bupa Health Insurance Co. LtdB2bclaimbcp@maxbupa.com1860-500-8888Not Availablehttps://transaction.maxbupa.com/Pages/claimdocupload.aspx
11Reliance General Insurance Co.Ltdrgicl.rcarehealth@relianceada.com1800-3009https://www.reliancegeneral.co.in/Insurance/Self-Help/Intimate-Claim-Health.aspxReliance Self-i App Mobile Application
12Care Health Insurance Ltd(formerly known as Religare Health Insurance Co. Ltd.)Customerfirst@careinsurance.com1800-102-4488https://www.religarehealthinsurance.com/rhicl/claim/loginhttps://www.religarehealthinsurance.com/rhicl/claim/login
13Star Health & Allied Insurance Co.Ltd.support@starhealth.in1800-103-8318https://www.starhealth.in/claims#1Not Available
14Universal Sompo General Insurance Co. Ltd.contactclaims@universalsompo.com1800-200-5142https://www.universalsompo.com/ClaimIntimation/Not Available
15HDFC ERGO Health Insurance Limited (Formerly Apollo Munich Health Insurance Company Limited)care@hdfcergo.com022-6234 6234https://customersupport.hdfcergo.com/customer-care/claim-registration.html?https://customersupport.hdfcergo.com/customer-care/claim-registration.html?
16Bharti AXA General Insurance Co. Ltd.claims@bhartiaxa.com1800-103-2292Not AvailableNot Available
17Cholamandalam MS General Insurance Co. Ltd.customercare@chola.murugappa.com1800-208-5544https://claimscustomerportal.cholainsurance.com/intimate-claimhttps://claimscustomerportal.cholainsurance.com/reimbursement-claim
18Manipal Cigna Health Insurance Company Limitedcustomercare@manipalcigna.com1800-102-4462Not AvailableNot Available
19Navi General Insurance Ltd.insurance.help@navi.com1800-123-0004Not AvailableNot Available
20Edelweiss General Insurance Co. Ltd.support@edelweissinsurance.com1800-12000Not AvailableNot Available
21IFFCO TOKIO General Insurance Co. Ltd.support@iffcotokio.co.in1800-103-5499Not AvailableNot Available
22Kotak Mahindra General Insurance Co. Ltd.care@kotak.com1800-266-4545https://www.kotakgeneralinsurance.com/claims/claim-intimation-formNot Available
23Magma HDI General Insurance Co. Ltd.customercare@magma-hdi.co.in1800-266-3202https://www.magmahdi.com/claimsNot Available
24National Insurance Co. Ltd.nic.health@nic.co.in1800-345-0330Not AvailableNot Available
25Raheja QBE General Insurance Co. Ltd.customercare@rahejaqbe.com1800-102-7723Not AvailableNot Available
26Reliance Health Insurance Ltd.rgicl.rcarehealth@relianceada.com1800-3009https://www.reliancegeneral.co.in/Insurance/Self-Help/Intimate-Claim-Health.aspxReliance Self-i App Mobile Application
27Royal Sundaram General Insurance Co. Ltd.customer.services@royalsundaram.in1860-258-0000Not AvailableNot Available
28SBI General Insurance Co. Ltd.customer.care@sbigeneral.in1800-102-1111https://www.sbigeneral.in/portal/claim/claims-intimationNot Available
29Shriram General Insurance Co. Ltd.compliance@shriramgi.com1800-103-3009https://www.shriramgi.com/insurance-claim-intimation-online.htmlNot Available
30Tata AIG General Insurance Co. Ltd.customersupport@tataaig.com1800-266-7780https://www.tataaig.com/service/claim-registerNot Available
31The New India Assurance Co. Ltdtech.support@newindia.co.in1800-209-1415Not AvailableNot Available
32The Oriental Insurance Co. Ltd.csd@orientalinsurance.co.in1800-118-485https://orientalinsurance.org.in/claimNot Available
33United India Insurance Co. Ltd.customercare@uiic.co.in1800-425-333-33https://portal.uiic.in/GCWebPortal/GCclaim/GCCustomerClaim.doNot Available
Sr. No.TPA NameEmail IdPhone NoOnline Intimation LinkOnline Claim Submission
1Heritage Health Insurance TPA Private Limitedheritage_health@bajoria.in1800-345-3477http://223.31.103.204/HeritageHealthTPA/HOME/CardSearch.aspx?Type=WebIntNot Available
2Rothshield Insurance TPA Limitedinfo@rothshield.co.in1800 228 144http://tpa.rothshield.co.in/OnlineIntimation.aspx
3Alankit Insurance TPA Limitedintimation@alankit.com1800-11-3300http://www.alankithealthcare.com/GetClaim.aspxhttp://14.142.94.239/alankitonlinefileupload
4Anmol Medicare Insurance TPA Limitedinquiry@anmolmedicare.com1800-233-1999http://www.anmolmedicare.in/Anmol/onlineintimation.aspxNot Available
5Genins India Insurance TPA Limitedgil@geninsindia.com0120-4144100http://www.geninsindia.com/CLAIMINTIMATION.ASPXhttp://geninsdms.com/file
6Safeway Insurance TPA Private Limitedcontact@safewaytpa.in1800 102 5671http://www.safewaytpa.in/claim_intimation_web.aspxNot Available
7Health Insurance TPA of India Limitedcustomerservice@hitpa.co.in1800 180 3600https://hitpa.co.in/Intimate-ClaimNot Available
8Medi Assist Insurance TPA Private Limitedinfo@mediassist.in1800-425-9449https://m.medibuddy.in/intimatereimbursement.aspxhttps://portal.medibuddy.in/Home.aspx?ReturnUrl=http%3a%2f%2fportal.medibuddy.in%2fClaimSubmission.aspx
9MDIndia Health Insurance TPA Private Limitedcustomercare@mdindia1800-209-7777https://mdindiaonline.com/ClaimIntimationForm.aspxhttps://mdindiaonline.com/ClaimUploadDocType.aspx
10Park Mediclaim Insurance TPA Private Limitedpark@parkmediclaim.co.in1800-11-55-33https://parkmediclaim.co.in/Intimation/ClaimIntimationNot Available
11Vidal Health Insurance TPA Private Limitedhelp@vidalhealthtpa.com1860-425-0251https://tips.vidalhealthtpa.com/vidalhealth/loginClmIntimation.htmhttps://www.vidalhealthtpa.com/home/Our-Services/Vidal-TPA-Services/Comprehensive-Claim-Management/tab11/textBlock_files/file1/User%20Manual%20-%20Online%20Claim%20Submission.pdf
12Vision Digital Insurance TPA Private Limitedcustomercare@visiontpa.in18001029982https://visiontpa.in/OnlineIntimation.aspxNot Available
13Good Health Insurance TPA Limitedcustomer.care@ghpltpa.com1860-425-3242https://webace.goodhealthtpa.in/GhCardIntimate.aspxNot Available
14East West Assist Insurance TPA Private Limitedassistance@eastwestassist.com011-47222666https://www.eastwestassist.com/https://www.eastwestassist.com/
15Ericson Insurance TPA Private Limitedintimation@ericsontpa.com1800-202-2034https://www.ericsontpa.com/OnlineIntimation.aspxhttps://www.ericsontpa.com/UploadClaimDocuments.aspx
16Family Health Plan Insurance TPA Limitedintimation@fhpl.net1800-425-4033https://www.fhpl.net/Main/ClaimIntimationNot Available
17Health India Insurance TPA Services Private Limitedfrd@healthindiatpa.com022-66131199https://www.healthindiatpa.com/ClaimIntimation/Web_Claim_Intimation.aspxNot Available
18Medsave Health Insurance TPA Limitedinfo@medsave.in011 -71221234https://www.medsave.in/MedSave-Intimation.aspx?val=OUThttps://www.medsave.in/MedsaveAuth/Frm_SubmitReimb.aspx
19Paramount Health Services & Insurance TPA Private Limitedcontact.phs@paramounttpa.com1800-226-655https://www.paramounttpa.com/Home/claimintimation.aspxNot Available
20Raksha Health Insurance TPA Private Limitedcrcm@rakshatpa.com0129-428-9999https://www.rakshatpa.com/WebPortal/Login/ClaimIntimationNot Available
21Vipul Medcorp Insurance TPA Private Limitedgi@vipulmedcorp.com0124 483 3900https://www.vipulmedcorp.com/Pub_intimation.aspxNot Available
22United Health Care Parekh Insurance TPA Private Limitedcustomerservice@uhcpindia.com1800-209-8884Not AvailableNot Available

These details have been collated and appear to be accurate as on the date of documentation. Please do note that these are subject to change.

FAQ’s

Q – If I was unable to send an intimation for a claim what will be the impact for it?

A – There is a possibility that the insurer or TPA will raise a query for reason of non-intimation. The law allows you to provide a justification for the same. Based on your communication, on reasonable grounds, no insurer can deny a health insurance claim for non-intimation. While the regulator has been specified on this clause and wants the insurers to ensure that no genuine claim is denied basis inability to intimate, the courts and the integrated grievance redressal mechanism of the regulator is available for you to reach out to. 

Q – If I delay sending the claim intimation, then what will be the impact?

A – Your reimbursement claim can get delayed in the absence of a reasonable reason for delay or non-intimation.

Q – What is the difference between cashless and reimbursement claims intimation?

A – Generally the authorisation sent by the hospital is taken as a surrogate for claim intimation. This therefore means that in a reimbursement claim, the policyholder needs to be more diligent about doing the intimation. 

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