Claim intimation clause in health insurance policies is a mandatory clause. This clause refers to the obligation of the A person who pays a premium to an insurance company in exchange for the insurance protection provided by a policy More to formally inform the insurance company (or their third party administrator) about a potential claim under the The legal document issued to the policyholder that outlines the conditions and terms of the insurance; also called the ‘policy More.
This clause typically puts timelines for intimating the insurer. The imitation can be done via any mode of communication. It is advisable that you keep a record of this communication such that in cases where there may be a difference of opinion on having met this requirement, you can share it with the insurer.
In case of hospitalisation, either as an emergency case or as a reimbursement case, this clause is equally applicable.
In emergency cases this needs to be done within 24 hours of getting admitted to the hospital.
In planned cases, this needs to be done 48 hours prior to hospitalisation.
Why is intimation required?
Claim intimation is required mostly by the insurers for two main reasons:
- To account for a potential payout to be made under the The legal document issued to the policyholder that outlines the conditions and terms of the insurance; also called the ‘policy More
- To investigate a claim if the insurer feels that any direct or indirect mechanism needs to be activated to adjudicate and verify on the genuineness of the claim
Where to file my health insurance intimation?
You can file for intimation in the following ways:
- Send an email to the insurer
- Call the insurer on their general helpline
- Many insurers have a form on their website to facilitate claim intimation
Claim Intimation under Health Insurance The legal document issued to the policyholder that outlines the conditions and terms of the insurance; also called the ‘policy More
Often policyholders are at a loss to access information with the relevant details on where to intimate and how to intimate.
This article provides all contact details of all TPA’s and Insurers along with their email id’s and phone numbers to initiate claim intimation. Once the intimation has been done, kindly keep the interaction details handy. Often you may be allocated a transaction Id number which will confirm the receipt of your intimation.
Please note the following indicative list of insurers and TPA’s for claim intimation:
|Sr. No.||Insurer||Email Id||Phone No||Online Intimation Link||Online claim Submission|
|1||Acko General Insurance Ltd.||email@example.com||1800-266-2256||ACKO Mobile Application||ACKO Mobile Application|
|2||Aditya Birla Health Insurance Co. Ltd.||firstname.lastname@example.org||1800-270-700||https://email@example.com|
|3||Bajaj Allianz General Insurance Co. Ltdfirstname.lastname@example.org||1800-209-5858||https://www.bajajallianz.com/claims/health-insurance/claim-process.html||Caringly Yours Mobile App|
|4||Cholamandalam MS General Insurance Co. Ltd.||email@example.com||1800-208-5544||https://claimscustomerportal.cholainsurance.com/intimate-claim||https://claimscustomerportal.cholainsurance.com/reimbursement-claim|
|5||Future Generali India Insurance Co. Ltd.||firstname.lastname@example.org||1800 103 8889||https://general.futuregenerali.in/health-claim-intimation||Not Available|
|6||Go Digit General Insurance Ltdemail@example.com||1800-258-4242||https://www.godigit.com/health-insurance/file-a-claim||https://www.godigit.com/health-insurance/file-a-claim|
|7||HDFC ERGO General Insurance Co.Ltd.||firstname.lastname@example.org||022-6234 6234||https://customersupport.hdfcergo.com/customer-care/claim-registration.html?||https://customersupport.hdfcergo.com/customer-care/claim-registration.html?|
|8||ICICI LOMBARD General Insurance Co. Ltd.||email@example.com||18002666||IL Take Care Mobile Application||IL Take Care Mobile Application|
|9||Liberty General Insurance Ltd.||firstname.lastname@example.org||1800-266-5844||Not Available||http://bit.ly/myonlineclaim|
|10||Max Bupa Health Insurance Co. Ltd||B2bclaimbcp@maxbupa.com||1860-500-8888||Not Available||https://transaction.maxbupa.com/Pages/claimdocupload.aspx|
|11||Reliance General Insurance Co.Ltdemail@example.com||1800-3009||https://www.reliancegeneral.co.in/Insurance/Self-Help/Intimate-Claim-Health.aspx||Reliance Self-i App Mobile Application|
|12||Care Health Insurance Ltd(formerly known as Religare Health Insurance Co. Ltd.)||Customerfirst@careinsurance.com||1800-102-4488||https://www.religarehealthinsurance.com/rhicl/claim/login||https://www.religarehealthinsurance.com/rhicl/claim/login|
|13||Star Health & Allied Insurance Co.Ltd.||firstname.lastname@example.org||1800-103-8318||https://www.starhealth.in/claims#1||Not Available|
|14||Universal Sompo General Insurance Co. Ltd.||email@example.com||1800-200-5142||https://www.universalsompo.com/ClaimIntimation/||Not Available|
|15||HDFC ERGO Health Insurance Limited (Formerly Apollo Munich Health Insurance Company Limited)||firstname.lastname@example.org||022-6234 6234||https://customersupport.hdfcergo.com/customer-care/claim-registration.html?||https://customersupport.hdfcergo.com/customer-care/claim-registration.html?|
|16||Bharti AXA General Insurance Co. Ltd.||email@example.com||1800-103-2292||Not Available||Not Available|
|17||Cholamandalam MS General Insurance Co. Ltd.||firstname.lastname@example.org||1800-208-5544||https://claimscustomerportal.cholainsurance.com/intimate-claim||https://claimscustomerportal.cholainsurance.com/reimbursement-claim|
|18||Manipal Cigna Health Insurance Company Limitedemail@example.com||1800-102-4462||Not Available||Not Available|
|19||Navi General Insurance Ltd.||firstname.lastname@example.org||1800-123-0004||Not Available||Not Available|
|20||Edelweiss General Insurance Co. Ltd.||email@example.com||1800-12000||Not Available||Not Available|
|21||IFFCO TOKIO General Insurance Co. Ltd.||firstname.lastname@example.org||1800-103-5499||Not Available||Not Available|
|22||Kotak Mahindra General Insurance Co. Ltd.||email@example.com||1800-266-4545||https://www.kotakgeneralinsurance.com/claims/claim-intimation-form||Not Available|
|23||Magma HDI General Insurance Co. Ltd.||firstname.lastname@example.org||1800-266-3202||https://www.magmahdi.com/claims||Not Available|
|24||National Insurance Co. Ltd.||email@example.com||1800-345-0330||Not Available||Not Available|
|25||Raheja QBE General Insurance Co. Ltd.||firstname.lastname@example.org||1800-102-7723||Not Available||Not Available|
|26||Reliance Health Insurance Ltd.||email@example.com||1800-3009||https://www.reliancegeneral.co.in/Insurance/Self-Help/Intimate-Claim-Health.aspx||Reliance Self-i App Mobile Application|
|27||Royal Sundaram General Insurance Co. Ltd.||firstname.lastname@example.org||1860-258-0000||Not Available||Not Available|
|28||SBI General Insurance Co. Ltd.||email@example.com||1800-102-1111||https://www.sbigeneral.in/portal/claim/claims-intimation||Not Available|
|29||Shriram General Insurance Co. Ltd.||firstname.lastname@example.org||1800-103-3009||https://www.shriramgi.com/insurance-claim-intimation-online.html||Not Available|
|30||Tata AIG General Insurance Co. Ltd.||email@example.com||1800-266-7780||https://www.tataaig.com/service/claim-register||Not Available|
|31||The New India Assurance Co. Ltdfirstname.lastname@example.org||1800-209-1415||Not Available||Not Available|
|32||The Oriental Insurance Co. Ltd.||email@example.com||1800-118-485||https://orientalinsurance.org.in/claim||Not Available|
|33||United India Insurance Co. Ltd.||firstname.lastname@example.org||1800-425-333-33||https://portal.uiic.in/GCWebPortal/GCclaim/GCCustomerClaim.do||Not Available|
|Sr. No.||TPA Name||Email Id||Phone No||Online Intimation Link||Online Claim Submission|
|1||Heritage Health Insurance TPA Private Limitedemail@example.com||1800-345-3477||http://18.104.22.168/HeritageHealthTPA/HOME/CardSearch.aspx?Type=WebInt||Not Available|
|2||Rothshield Insurance TPA Limitedfirstname.lastname@example.org||1800 228 144||http://tpa.rothshield.co.in/OnlineIntimation.aspx|
|3||Alankit Insurance TPA Limitedemail@example.com||1800-11-3300||http://www.alankithealthcare.com/GetClaim.aspx||http://22.214.171.124/alankitonlinefileupload|
|4||Anmol Medicare Insurance TPA Limitedfirstname.lastname@example.org||1800-233-1999||http://www.anmolmedicare.in/Anmol/onlineintimation.aspx||Not Available|
|5||Genins India Insurance TPA Limitedemail@example.com||0120-4144100||http://www.geninsindia.com/CLAIMINTIMATION.ASPX||http://geninsdms.com/file|
|6||Safeway Insurance TPA Private Limitedfirstname.lastname@example.org||1800 102 5671||http://www.safewaytpa.in/claim_intimation_web.aspx||Not Available|
|7||Health Insurance TPA of India Limitedemail@example.com||1800 180 3600||https://hitpa.co.in/Intimate-Claim||Not Available|
|8||Medi Assist Insurance TPA Private Limitedfirstname.lastname@example.org||1800-425-9449||https://m.medibuddy.in/intimatereimbursement.aspx||https://portal.medibuddy.in/Home.aspx?ReturnUrl=http%3a%2f%2fportal.medibuddy.in%2fClaimSubmission.aspx|
|9||MDIndia Health Insurance TPA Private Limited||customercare@mdindia||1800-209-7777||https://mdindiaonline.com/ClaimIntimationForm.aspx||https://mdindiaonline.com/ClaimUploadDocType.aspx|
|10||Park Mediclaim Insurance TPA Private Limitedemail@example.com||1800-11-55-33||https://parkmediclaim.co.in/Intimation/ClaimIntimation||Not Available|
|11||Vidal Health Insurance TPA Private Limitedfirstname.lastname@example.org||1860-425-0251||https://tips.vidalhealthtpa.com/vidalhealth/loginClmIntimation.htm||https://www.vidalhealthtpa.com/home/Our-Services/Vidal-TPA-Services/Comprehensive-Claim-Management/tab11/textBlock_files/file1/User%20Manual%20-%20Online%20Claim%20Submission.pdf|
|12||Vision Digital Insurance TPA Private Limitedemail@example.com||18001029982||https://visiontpa.in/OnlineIntimation.aspx||Not Available|
|13||Good Health Insurance TPA Limitedfirstname.lastname@example.org||1860-425-3242||https://webace.goodhealthtpa.in/GhCardIntimate.aspx||Not Available|
|14||East West Assist Insurance TPA Private Limitedemail@example.com||011-47222666||https://www.eastwestassist.com/||https://www.eastwestassist.com/|
|15||Ericson Insurance TPA Private Limitedfirstname.lastname@example.org||1800-202-2034||https://www.ericsontpa.com/OnlineIntimation.aspx||https://www.ericsontpa.com/UploadClaimDocuments.aspx|
|16||Family Health Plan Insurance TPA Limitedemail@example.com||1800-425-4033||https://www.fhpl.net/Main/ClaimIntimation||Not Available|
|17||Health India Insurance TPA Services Private Limitedfirstname.lastname@example.org||022-66131199||https://www.healthindiatpa.com/ClaimIntimation/Web_Claim_Intimation.aspx||Not Available|
|18||Medsave Health Insurance TPA Limitedemail@example.com||011 -71221234||https://www.medsave.in/MedSave-Intimation.aspx?val=OUT||https://www.medsave.in/MedsaveAuth/Frm_SubmitReimb.aspx|
|19||Paramount Health Services & Insurance TPA Private Limitedfirstname.lastname@example.org||1800-226-655||https://www.paramounttpa.com/Home/claimintimation.aspx||Not Available|
|20||Raksha Health Insurance TPA Private Limitedemail@example.com||0129-428-9999||https://www.rakshatpa.com/WebPortal/Login/ClaimIntimation||Not Available|
|21||Vipul Medcorp Insurance TPA Private Limitedfirstname.lastname@example.org||0124 483 3900||https://www.vipulmedcorp.com/Pub_intimation.aspx||Not Available|
|22||United Health Care Parekh Insurance TPA Private Limitedemail@example.com||1800-209-8884||Not Available||Not Available|
These details have been collated and appear to be accurate as on the date of documentation. Please do note that these are subject to change.
Q – If I was unable to send an intimation for a claim what will be the impact for it?
A – There is a possibility that the insurer or TPA will raise a query for reason of non-intimation. The law allows you to provide a justification for the same. Based on your communication, on reasonable grounds, no insurer can deny a health insurance claim for non-intimation. While the regulator has been specified on this clause and wants the insurers to ensure that no genuine claim is denied basis inability to intimate, the courts and the integrated grievance redressal mechanism of the regulator is available for you to reach out to.
Q – If I delay sending the claim intimation, then what will be the impact?
A – Your reimbursement claim can get delayed in the absence of a reasonable reason for delay or non-intimation.
Q – What is the difference between cashless and reimbursement claims intimation?
A – Generally the authorisation sent by the hospital is taken as a surrogate for claim intimation. This therefore means that in a reimbursement claim, the A person who pays a premium to an insurance company in exchange for the insurance protection provided by a policy More needs to be more diligent about doing the intimation.