How to File a Claim with IFFCO Tokio Health Insurance?

How to File a Claim with IFFCO Tokio Health Insurance?

IFFCO Tokio General Insurance Company follows a seamless and user-friendly claims process. The insurer prioritizes transparency in communication so policyholders are kept informed throughout the claim process. If you have an IFFCO Tokio health insurance policy, you can follow the detailed guidelines and tips on documentation and timelines as given below:

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Ways to File an IFFCO Tokio Health Insurance Claim

IFFCO Tokio General Insurance Company offers two options for filing health insurance claims i.e. Cashless and Reimbursement.

1. Cashless Claims

   IFFCO Tokio provides a hassle-free cashless claim process for policyholders at its partnered network hospitals. This means that medical services can be received without needing immediate payments, which is particularly beneficial in emergencies. The process is designed to be efficient and quick, providing timely support when required. In the network hospital, the policyholder's eligibility for cashless treatment is verified and facilitated promptly.

2. Reimbursement Claims

   If policyholders receive treatment at hospitals that are not part of IFFCO Tokio's network, they can still claim reimbursement for the expenses incurred. This makes it convenient for policyholders to choose any healthcare provider they prefer while ensuring a structured process for reimbursement. Policyholders should arrange and keep all relevant medical bills and documents to make the process smoother.

How to File an IFFCO Tokio Health Insurance Claim Online with Policybazaar?

For Policybazaar customers, initiating an IFFCO Tokio health insurance claim online is simple and the steps are given below:

Step 1: Contact the Policybazaar claim support team immediately after hospitalization. Call them at 1800-258-5881 or email at care@policybazaar.com.

Step 2: Alternatively, visit Policybazaar.com and click on 'File a New Claim' in the 'Claims' section.

Step 3: Choose 'Health Insurance' and sign in using your mobile number and OTP/password.

Step 4: Complete the instructions and select 'File a new claim.'

Once your claim is filed, Policybazaar will coordinate with IFFCO Tokio General Insurance Company.

How to File a Claim with IFFCO Tokio Health Insurance?

The procedure for IFFCO Tokio Health Insurance cashless and reimbursement claims is given below:c

1. IFFCO Tokio Health Insurance Cashless Claim Process:

   Here's a step-by-step guide to the cashless claim process:

   Intimation to the Insurer

   Contact IFFCO Tokio's TPA via their toll-free number when you are admitted to a network hospital. Remember to provide your health card membership number for quick reference.

   Cashless Request Form Completion

   Obtain the cashless request form from the hospital's insurance help desk. Fill it out accurately and have it certified by your treating doctor to ensure all medical details are correctly represented.

   Submission of the Request Form

   Fax or e-mail the completed cashless request form along with any supporting medical records to the TPA. This step is crucial for the TPA to start processing your claim.

   TPA's Document Scrutiny and Decision

   Await the TPA's decision after they review your submitted documents. They might approve the cashless request or ask for additional documents if necessary.

   Direct Settlement of Hospital Bills

   Upon TPA's approval of your cashless claim, the hospital bills will be settled directly as per your policy limits. However, your responsibility will be non-medical expenses like telephone charges, food, and attendant charges.

2. IFFCO Tokio Health Insurance Reimbursement Claim Process:

   Follow these steps for filing a reimbursement claim:

   Timely Intimation to Insurer

   Inform IFFCO Tokio Health Insurance through their toll-free number immediately upon hospital admission and not later than 7 days from the date of discharge, quoting your policy certificate number.

   Settlement of Bills and Document Collection

   Settle all hospital bills personally and collect all necessary medical documents including discharge summary, bills, prescriptions, and diagnostic reports.

   Claim Form Acquisition and Submission

   Download the relevant claim form from IFFCO Tokio's website or request one through their call centre. Fill it meticulously and submit it with all the required original documents.

   Detailed Documentation

   Ensure that you submit detailed bills, prescriptions, advance and final receipts, and all diagnostic test reports, such as X-rays, scans, and ECGs.

   Submission of Additional Documents if Needed

   Be prepared to provide any additional documents that the claim processing team might request to process your claim efficiently.

   Awaiting Claim Processing and Reimbursement

   Once all documents are submitted, the claim will be processed according to IFFCO Tokio's terms and conditions, and the reimbursement will be made accordingly.

Documents Required to File an IFFCO Tokio Health Insurance Claim

For a seamless claim process with IFFCO Tokio Health Insurance, ensure to submit these documents for reimbursement claims:

• Duly filled claim form with Doctor's certificate
• Discharge summary from the hospital
• Detailed itemized bills
• Prescriptions corresponding to the bills
• Advance and final receipts for payments made
• Diagnostic Test Reports, including X-Ray, Scan, ECG, and others
• Doctor's consultation notes or medical records
• Any other relevant medical documentation supporting the treatment
• NEFT details for direct transfer of claim amount
• Copy of the patient's ID proof for verification
• FIR or Medico-Legal Certificate (MLC), in case of accident claims
• KYC documents for the claimant

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