Everything you Need to Know about Digit Health Insurance Claims

A health insurance claim is a formal request that you make to your insurance provider. The claim process helps you get compensation for your healthcare and medical costs from your health insurance provider. For instance, if a family member gets hospitalized due to an illness that is covered under your health insurance plan then you claim for the expenses incurred. If you have a Digital health insurance policy then you can choose to avail of cashless treatment in a network hospital or even file for reimbursement of the hospitalization expenses. 

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    Types of Digit Health Insurance Claims

    All those who are insured under a Digit health insurance plans can choose to file a cashless claim or reimbursement claim. Both of them are explained below:

    • Digit Health Insurance Cashless Claim- Digit cashless health insurance claims mean you don’t need to pay anything from your pocket if you choose to avail treatment at any of the hospitals that are registered with Digit General Insurance Company Ltd. Based on your health insurance plan, Digit health plans will cover your treatment costs. Though, the extent of this will depend on your health plan and its coverage benefits.  
    • Digit Health Insurance Reimbursement Claim- One of the most common types of health insurance claims are reimbursement claims. You can file reimbursement claims for treatment availed at any of the hospitals, be it a network hospital or non-network hospital. As per your Digit health insurance plan and its coverage benefits, you can file for reimbursement within 15 days of getting discharged from the hospital.

    How to file a Cashless Claim for Digit Health Insurance Plan?

    Digit General Insurance Company follows a transparent claim process so that their customers know what they can expect from them.  We have put together the complete list of steps of filing a cashless claim in Network Hospitals.

    Step 1: You need to inform the insurance company at least two to three days in advance for a planned hospitalization. In case of an emergency, you need to inform the insurer within 24-hours of getting admitted in the hospital.

    Step 2: Show your e-health card at the Insurance helpdesk or Mediassist at the hospital for the pre-approval form.

    Step 3: Submit the signed and filled form at the helpdesk.

    Step 4: Once you get a go-ahead you can avail of the cashless treatment facility within 15 days from the date of approval.

    How to file a Reimbursement Claim for Digit Health Insurance Plan?

    If you want to get a reimbursement for your hospitalization expenses then the steps you can follow are given below:

    Step 1: You need to call the insurance company within two days of getting admitted in the hospital. After that the insurer will share a link to upload the soft copies of all the original documents including reports, bills, etc.).

    Step 2:  You need to sign all the documents before uploading them. Do not forget to write ‘For Digit Insurance’ on them. The insurer can ask for any of the original documents so it’s better that you keep them all handy.

    Step 3: You need to upload all the documents within 30 days from getting discharged or on receiving the link.

    Step 4: And for any additional requirements the insurer will share the details with you.

    Step 5: You will receive the payment within 30 days of receiving the last necessary claim document. 

    Note: All the claims are processed and settled quickly. Coming to cashless claims and Advance Cash Benefits, the approvals are given a quick as within 24-hours. And the reimbursement claim requests are settled within 30 days of the claim receipt.

    Co-payment- There are no-payments involved. Therefore, you don’t need to pay anything from your own pocket

    Number of health claims in a year- You can file unlimited claims in one year up to the sum insured limit

    Documents Required for Digit Health Insurance Claims

    For both cashless and reimbursement claims, here is a list of documents that you will require for Digit health insurance claims. The listed documents can vary from one claim to another and you can check the ones that you will need as per your situation.

    List of Documents

    Hospitalization Claim

    Daily Hospital Cash Claim

    Critical Illness Claim

    Claim form  (Duly Filled and Signed)

    Original Hospital Main Bill

    ×

    ×

    Medical Records

    ×

    Discharge Summary

    ×

    Original Pharmacy Bills with Prescriptions

    ×

    ×

    Original Hospital Bill with breakup

    ×

    ×

    CDs/Digital Images of the Investigation Procedures (if required)

    ×

    ×

    KYC (Photo ID Card) Bank Details with Cancelled Cheque

    Investigation & Consultation Papers

    ×

    Documents required in specific cases

     

    Pregnancy related claims- Birth discharge Summary, Ante-natal Record

    ×

    ×

    Accidental Case- MLC/FIR Report

    ×

    Claims related to disability or death - Post Mortem Report, Death Certificate or Disability Certificate Original Invoice/Sticker (If applicable)

    ×

    ×

    Attending Doctor’s Certificate (If applicable)

     

    (Source: Digit General Insurance Company Limited)

    For claim related queries you can speak to our customer care team who will take you through the entire process. You can also call Digit General Insurance Company’s helpline number i.e. 1800-258-4242 or email them at healthclaims@godigit.com. The insurer is available round the clock even on National Holidays.

    Written By: PolicyBazaar - Updated: 30 July 2021

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