Common use of Reimbursement Claims Procedure Clause in Contracts

Reimbursement Claims Procedure. If Pre-authorisation as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co- insurer should be submitted **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  Claim form with NEFT details & cancelled cheque duly signed by Insured  Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  Attested copies of Indoor case papers  Original/Attested copies Final Hospital Bill with breakup of surgical charges, surgeon’s fees, OT charges etc  Original Paid Receipt against the final Hospital Bill.  Original bills towards Investigations done / Laboratory Bills.  Original/Attested copies of Investigation Reports against Investigations done.  Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable)  Cashless settlement letter or other company settlement letter  First consultation letter for the current ailment.  In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT park, Off Nagar Road, Xxxxx Nagar Pune 411014| Toll free: 0000-000-0000, 0000-00-0000

Reimbursement Claims Procedure. If Pre-authorisation authorization as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox photo copies attested by the co- co-insurer should be submitted **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  • Claim form with NEFT details & cancelled cheque duly signed by Insured  • Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  • Attested copies of Indoor case papers  • Original/Attested copies Final Hospital Bill with breakup of surgical ofsurgical charges, surgeon’s surgeon‘s fees, OT charges OTcharges etc  • Original Paid Receipt against the final Hospital Bill.  • Original bills towards Investigations done / Laboratory Bills.  • Original/Attested copies of Investigation Reports against Investigations done.  • Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable)  ). • Cashless settlement letter or other company settlement letter  • First consultation letter for the current ailment.  • In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor0xx Xxxxx, Bajaj Finserv BuildingXxxxx Xxxxxxx Xxxxxxxx, Behind Weikfield IT parkPark, Off Nagar Road, Xxxxx Nagar Pune 411014| Toll free: 0000-000-0000, 0000-00-0000

Reimbursement Claims Procedure. If Pre-authorisation authorization as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox photo copies attested by the co- co-insurer should be submitted **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  Claim form with NEFT details & cancelled cheque duly signed by Insured  Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  Attested copies of Indoor case papers  Original/Attested copies Final Hospital Bill with breakup of surgical ofsurgical charges, surgeon’s surgeon‘s fees, OT charges OTcharges etc  Original Paid Receipt against the final Hospital Bill.  Original bills towards Investigations done / Laboratory Bills.  Original/Attested copies of Investigation Reports against Investigations done.  Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable) ).  Cashless settlement letter or other company settlement letter  First consultation letter for the current ailment.  In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT parkPark, Off Nagar Road, Xxxxx Nagar Pune 411014| Toll free: 0000-000-0000, 0000-00-0000

Reimbursement Claims Procedure. If Pre-authorisation as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & and 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co- co-insurer should be submitted *Note: In case You are claiming for the same event under an indemnity based policy of another insurer and are required to submit the original documents related to Your treatment with that particular insurer, then You may provide Us with the attested Xerox copies of such documents along with a declaration from the particular insurer specifying the availability of the original copies of the specified treatment documents with it. **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  Claim form with NEFT details & cancelled cheque duly signed by Insured  Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  Attested copies of Indoor case papers  Original/Attested copies Final Hospital Bill with breakup break up of surgical charges, surgeon’s fees, OT charges etc  Original Paid Receipt against the final Hospital Bill.  Original bills towards Investigations done / Laboratory Bills.  Original/Attested copies of Investigation Reports against Investigations done.  Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable) ).  Cashless settlement letter or other company settlement letter  First consultation letter for the current ailment.  In case of implant surgery, invoice & sticker. Health Administration Team, Please send the documents on below address Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT park, Off Nagar Road, Xxxxx Nagar Pune 411014| Toll free: 0000-000-0000, 00001800-0022-00005858

Reimbursement Claims Procedure. If Pre-authorisation authorization as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co- insurer should be submitted **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  Claim form with NEFT details & cancelled cheque duly signed by Insured  Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  Attested copies of Indoor case papers  Original/Attested copies Final Hospital Bill with breakup of surgical charges, surgeon’s fees, OT charges etc  Original Paid Receipt against the final Hospital Bill.  Original bills towards Investigations done / Laboratory Bills.  Original/Attested copies of Investigation Reports against Investigations done.  Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable) ).  Cashless settlement letter or other company settlement letter  First consultation letter for the current ailment.  In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT park, Off Nagar Road, Xxxxx Nagar Pune 411014| Toll free: 0000-000-0000, 0000-00-0000

Reimbursement Claims Procedure. If Pre-authorisation as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co- insurer should be submitted **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  • Claim form with NEFT details & cancelled cheque duly signed by Insured  • Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  • Attested copies of Indoor case papers  • Original/Attested copies Final Hospital Bill with breakup of surgical charges, surgeon’s fees, OT charges etc  • Original Paid Receipt against the final Hospital Bill.  • Original bills towards Investigations done / Laboratory Bills.  • Original/Attested copies of Investigation Reports against Investigations done.  • Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable)  • Cashless settlement letter or other company settlement letter  • First consultation letter for the current ailment.  • In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT park, Off Nagar Road0xx Xxxxx, Xxxxx Nagar Xxxxxxx Xxxxxxxx, Xxxxxx Xxxxxxxxx XX xxxx, Xxx Xxxxx Xxxx, Xxxxx Xxxxx Pune 411014| Toll free: 0000-000-0000, 0000-00-0000

Reimbursement Claims Procedure. If Pre-authorisation authorization as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization ii. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy. iv. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our cost. v. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation as listed out in greater detail below and other information We ask for to investigate the claim or Our obligation to make payment for it. vi. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co- insurer should be submitted **Note: Waiver of conditions (i) and (vi) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which You were placed, it was not possible for You or any other person to give notice or file claim within the prescribed time limit.  • Claim form with NEFT details & cancelled cheque duly signed by Insured  • Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  • Attested copies of Indoor case papers  • Original/Attested copies Final Hospital Bill with breakup of surgical charges, surgeon’s fees, OT charges etc  • Original Paid Receipt against the final Hospital Bill.  • Original bills towards Investigations done / Laboratory Bills.  • Original/Attested copies of Investigation Reports against Investigations done.  • Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable)  ). • Cashless settlement letter or other company settlement letter  • First consultation letter for the current ailment.  • In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT park, Off Nagar Road0xx Xxxxx, Xxxxx Nagar Xxxxxxx Xxxxxxxx, Xxxxxx Xxxxxxxxx XX xxxx, Xxx Xxxxx Xxxx, Xxxxx Xxxxx Pune 411014| Toll free: 0000-000-0000, 0000-00-0000

Reimbursement Claims Procedure. If Pre-authorisation as per Cashless Claims Procedure above is denied by Us or if treatment is taken in a Hospital other than a Network Hospital or if You do not wish to avail cashless facility, then: i. a. You or someone claiming on Your behalf must inform Us in writing immediately within with 48 hours of hospitalization in case of emergency hospitalization & 48 hours prior to hospitalization in case of planned hospitalization. ii. b. You must immediately consult a Doctor and follow the advice and treatment that he recommends. iii. c. You must take reasonable steps or measures to minimize minimise the quantum of any claim that may be made under this Policy. iv. d. You must have Yourself examined by Our medical advisors if We ask for this, and as often as We consider this to be necessary at our Our cost. v. e. You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation (written details of the quantum of any claim along with all original supporting documentation as listed out in greater detail below and other information We ask for to investigate per the claim or Our obligation to make payment for itclaims documents list specified below. vi. f. In the event of the death of the insured person, someone claiming on his behalf must inform Us in writing immediately and send Us a copy of the post mortem report (if any) within 30 days* vii. g. In event of a claim, the original documents to be submitted & after the completion of the claims assessment process the original documents may be returned if requested by the insured in writing, however we will retain the Xerox copies of the claim documents. h. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co- co-insurer should be submitted **Note: along with the letter confirming the status of the claim & settlement details if any Waiver of conditions (ia), (e) and (vif) may be considered in extreme cases of hardship where it is proved to Our the satisfaction of the Company that under the circumstances in which You were placed, the insured was placed it was not possible for You from him or any other person to give notice or file claim within the prescribed time limit.  List of claim documents i. Claim form with NEFT details & cancelled cheque Form duly signed by Insured  Original/Attested copies the insured. ii. Copy of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes  Attested copies Certificate. iii. Copy of Indoor case papers  Original/Attested copies Final Hospital Bill with breakup of surgical charges, surgeon’s fees, OT charges etc  Original Paid Receipt against the final Hospital Bill.  Original bills towards Investigations done / Laboratory Bills.  Original/Attested copies of Investigation Reports against Investigations done.  Original bills and receipts paid for the transportation from Registered Ambulance Service Provider. Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment (if Applicable)  Cashless settlement letter or other company settlement letter  First consultation letter for the current ailment.  In case of implant surgery, invoice & sticker. Health Administration Team, Bajaj Allianz General Insurance Company 2nd Floor, Bajaj Finserv Building, Behind Weikfield IT park, Off Nagar Road, Xxxxx Nagar Pune 411014| Toll free: 0000-000-0000, 0000-00-0000Xxxx