Collection of Claim Documents Sample Clauses

Collection of Claim Documents i. Wherever You have opted for a reimbursement of expenses, You may submit the following documents for reimbursement of the claim to Our branch or head office at your own expense not later than 15 days from the date of discharge from the Hospital. You can obtain a Claim Form from any of our Branch Offices or download a copy from our website xxx.xxxxxxxxxxxxxxxxx.xx ii. List of necessary claim documents to be submitted for reimbursement are as following: Copy of photo ID of patient Hospital Discharge summary Operation Theatre notes Hospital Main Bill Hospital Break up bill Investigation reports Doctors reference slip for investigation Pharmacy Bills MLC/ FIR report, Post Mortem Report if applicable and conducted KYC documents (Photo ID proof, address proof, recent passport size photograph) Cancelled cheque for NEFT payment Payment receipt. We may call for any additional documents/information as required based on the circumstances of the claim. iii. Our branch offices shall give due acknowledgement of collected documents to You. In case You/Insured Person delay submission of claim documents as specified in 5.(a) above, then in addition to the documents mentioned in VII.5. (a) above, You are also required to provide Us the reason for such delay in writing. In case You delay submission of claim documents, then in addition to the documents mentioned above, You are also required to provide Us the reason for such delay in writing. We will accept such requests for delay up to an additional period of 30 days from the stipulated time for such submission. We will condone delay on merit for delayed Claims where the delay has been proved to be for reasons beyond Your/Insured Persons control.

Collection of Claim Documents. The TPA shall offer a single window service to the Insured Persons for receiving the claim documents. TPA shall strive to secure all documents and information relating to a claim in electronic form and assist the Insured/Claimants in this regard. In case of pre-authorisation for the Cashless Access Service, the Network Provider will send the claim documents along with the invoice directly to the TPA. If the claim documents are collected by the Insured Person, the Insured Person should submit the same to the Regional/nearest office of the TPA as per the terms of the policy. If the Insured Person does not opt for a Network Provider, the Insured Person may collect the claim form from either Underwriting Office or the TPA or download the form from the website of the TPA. The documents for claim should be submitted to TPA by the Insured Person. The pre-& post hospitalisation claim documents will also be collected by the TPA office. TPA shall give due acknowledgement of collected documents. The TPA shall also take all steps as may be necessary on receipt of intimation of any claim, either by way of request, reminder, investigation or otherwise, to secure all documents or information from the Hospital, Insured or any other source for ascertaining and satisfying about the admissibility of the claim under the terms and conditions of the Policy of Insurance.