Common use of For Reimbursement Claims Clause in Contracts

For Reimbursement Claims. (i) For all claims for which Cashless Facilities have not been pre-authorised or for which treatment has not been taken at a Network Provider, We shall be given written notice of the claim along with the following details within 48 hours of admission to the Hospital or before discharge from the Hospital, whichever is earlier: (1) The Policy number; (2) Name of the Policyholder/Employer; (3) Name and address of the Insured Person/Employee/member in respect of whom the request is being made; (4) Health Card, photo ID, KYC documents; (5) Nature of Illness or Injury and the treatment/Surgery taken; (6) Name and address of the attending Medical Practitioner; (7) Hospital where treatment/Surgery was taken; (8) Date of admission and date of discharge; (9) Any other information that may be relevant to the Illness/ Injury/ Hospitalization; (10) Xxxx completed claim form. (ii) If the claim is not notified to Us within the earlier of 48 hours of the Insured Person’s admission to the Hospital or before the Insured Person’s discharge from the Hospital, then We shall be provided the reasons for the delay in writing. We will condone such delay on merits where the delay has been proved to be for reasons beyond the claimant’s control.

For Reimbursement Claims. (i) For all claims for which Cashless Facilities have not been pre-authorised or for which treatment has not been taken at a Network Provider, We shall be given written notice of the claim along with the following details within 48 hours of admission to the Hospital or before discharge from the Hospital, whichever is earlier: (1) The Policy number; (2) Name of the Policyholder/Employer; (3) Name and address of the Insured Person/Employee/member in respect of whom the request is being made; (4) Health Card, photo ID, KYC documents; (5) Nature of Illness or Injury and the treatment/Surgery taken; (6) Name and address of the attending Medical Practitioner; (7) Hospital where treatment/Surgery was taken; (8) Date of admission and date of discharge; (9) Any other information that may be relevant to the Illness/ Injury/ Hospitalization; (10) Xxxx Duly completed claim form. (ii) If the claim is not notified to Us within the earlier of 48 hours of the Insured Person’s admission to the Hospital or before the Insured Person’s discharge from the Hospital, then We shall be provided the reasons for the delay in writing. We will condone such delay on merits where the delay has been proved to be for reasons beyond the claimant’s control.