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FILE A CLAIM

Collect Your Bills & Receipts

To file a claim you need to first obtain an itemized bill from your medical provider. This bill will list every service you have received along with the cost. You should promptly send the itemized receipts post-discharge along with the duly filled Claim Form mentioning the required details.

Complete A Claim Form

A claim form is the document that tells us more details about the hospitalization and help us determine if the expenses you are claiming for are covered under your insurance policy terms & conditions or not, so the more information on this form the better. In case of any questions simply contact DAS.

Make At Least 1 Copy

As a preventative measure, it’s always a good idea to make copies of your entire claim before sending it to us/insurance company for settlement. Keep an extra copy of the completed claim form as well as your collected receipts in case there is a complication with your claim.

Review And Submit

When you are absolutely certain you have everything in order, you can physically submit your claim form and accompanying original documents to DAS. If you need an address to which to send it, please check your claim form or refer to our website for further details.

During claim processing if the claim documents are found to be deficient, DAS shall intimate the same to the respective Insured for fulfillment of the requirement. The claim will not be processed further unless the required documents are received from the Insured.

In view of this while submitting the claim documents, insured or hospital should make sure that claim documents are attached appropriately to avoid delays in claim settlement.

If the following information/documents are NOT PROVIDED it would be considered deficient:

  1. KYC documents – Photo Identity & Address proof for claim amount of 1 lakh & above.
  2. Photocopy of DAS ID Card.
  3. Original document of Discharge Card / Discharge Summary
  4. Original document of Hospital Bill & Payment Receipts
  5. Implants & IOL Stickers or Invoices in surgical cases.
  6. Original investigation reports & Medicine Prescriptions where required
  7. First Consultation Note/ Letter from treating doctor for hospitalization / history details
  8. Photocopy of the Indoor Case papers duly signed and stamped from the Hospital.
  9. Reason for No Intimation / Delayed Intimation if the claim is not intimated as per the policy T & C.
  10. Reason for Delay in Submission of claim documents if the claim is not submitted as per the policy T & C.
  11. Hospital Bill & other Outpatient bills which are supporting the break up.
  12. Incorrect age information – Age discrepancy due to mismatch of patient age as per policy data and age mentioned in hospital records.

Following steps are to be taken while submitting the claim documents:

  1. Claim form should be completely filled and duly signed by Insured.
  2. Original Claim documents should be submitted for reimbursement and a copy of all documents must be retained with the insured.
  3. Hospital bill should be supported with related break up of expenses incurred.
  4. Submit original Investigation reports & medicine bill prescriptions to support the claim.
  5. Submit KYC documents like Photo Identity & Address proof for high value claims (1 lakh & above).
  6. If the implants are used then it is mandatory to submit the stickers & supporting invoice for processing the claim.
  7. Intimation for Hospitalization must be made within the specified period of respective insurance company policy.
  8. Submission of claim documents must be within the specified period of respective insurance company policy.
  9. Patient Name, Age & Gender mentioned on Claim form, Hospital records, Insurance policy & KYC documents should be same.