Tata AIG Health Insurance Claim Settlement

What Are Tata AIG Health Insurance Cashless Claims?

Should you choose to claim your coverage cashlessly, your insurer and the hospital will settle the expenses internally. You will not have to pay a single penny beyond the extent of your copayment, deductible, etc. Moreover, cashless claims can be filed for unplanned and planned hospitalisation.

How to File a Tata AIG Health Insurance Cashless Claim

Here’s how you can file a cashless claim under Tata AIG Health Insurance for a planned or emergency hospitalisation.

• Step 1: Intimate the Insurer

Before a minimum of five days, inform the insurance company about your intention to file a claim. You can intimate them about this claim through the Tata AIG Self Service Portal or the Tata AIG app. You can also call them on their toll-free number (1800-266-7780) or write to them on their email address (healthclaimsupport@tataaig.com). You can also get in touch with them over WhatsApp on 9136160375. 

 

You may be asked for the following information during the intimation process. 

1. Name of the patient

2. Policy details

3. Name of the treatment, ailment, or procedure

4. Name and location of the hospital

5. Estimate

6. Date of admission and date of discharge

 

You will be given an intimation number which can be used further into the cashless claim settlement process. 

• Step 2: Submit the Documents

Once you choose a network hospital, carry medical documents, policy details, and a valid government identity proof with you. Reach out to the third-party administration desk at the hospital and submit those documents. The TPA desk will issue a cashless claim request on the TAGIC Cashless Pre-authorisation portal or on the designated email address. 

• Step 3: Offer Co-operation as the Claim is Being Processed

While the claim moves from one stage to the next, you may be asked for certain information or documents. Additional requests will be made only if important data is missing. Otherwise, the claim will be processed within 2-4 hours. 

 

An additional verification may also take place where a claim-processing team could visit the hospital to confirm the legitimacy of the claim application. The insurer may also consult their Underwriting Team as part of the process.

 

Once the claim has been processed, the hospital bills will be handled by the insurance company. However, if your claim has been rejected, you will be informed about it through your registered mobile number, email address, or WhatsApp. This intimation will also include notes that justify the rejection of your claim. 

What Are Tata AIG Health Insurance Reimbursement Claims?

Under such claims, you can take control of your hospital bills before the insurance company steps in to process the claim. First, you cover the expenses and next, you allow the insurance company to reimburse the amount to you. Reimbursement claims do not require you to specifically choose a network hospital to be able to access this manner of claims. 

How to File a Tata AIG Health Insurance Reimbursement Claim?

Here’s how you can file a reimbursement claim under Tata AIG Health Insurance. 

• Step 1: Inform the Insurer

Next, you can let the insurer know about your intention to file a claim. You can do so through their Tata AIG Self Service portal or the Tata AIG mobile application or the Tata AIG WhatsApp number. You can also call them on their toll-free number or write them an email. 

 

Through the aforementioned communications, you may be asked for the following information. 

1. The patient’s name

2. Details of your policy

3. The name of the treatment, procedure, or ailment

4. Information regarding the name and location of the hospital

5. Estimate

6. Date of admission

7. Date of discharge

 

After this, you will be given an intimation number which could be of use to you through the remaining stages of the claim process. 

• Step 2: Submit the Documents

You may be asked to upload soft copies of documents on the Tata AIG Self Service portal or Tata AIG app. Furthermore, documents may have to be sent to the following address. 

 

TATA AIG General Insurance Company Limited

5th and 6th Floor, Imperial Towers,  

H.No 7-1-6-617/A, GHMC No - 615,616,

Ameerpet, Hyderabad – 500016, Telangana

 

The Tata AIG Health Insurance claims team will generate an inward ID and a claim ID once they receive your documents. 

• Step 3: Processing the Claim

The claim will now undergo an evaluation and verification phase. The data provided by you will be verified and assessed thoroughly, along with your claim request. If the claims team finds that certain documents or details are missing, they will reach out to you for further clarification. 

 

The insurance company may send an investigation team to further verify your claim and to assess the situation thoroughly. You will receive an approval or rejection message from the insurer shortly after this process is completed. The reimbursement should take place within 15 days from the date of approval. 

Documents Required for Tata AIG Health Insurance Claims

Listed below are important or most commonly required documents you would need for cashless and reimbursement claims. 

• Cashless Claims

• Health insurance card

• Customer ID proof

• Passport-sized photograph

• Policy copies

• A duly filled CKYC claim form

• Address proof

 

Reimbursement Claims

 

• Insurance card

• Policy copy

• Pathological reports

• Original bills

• Investigation reports

• NEFT details

• Claim form

• Medical certificate

• Hospital discharge card

• Pharmacy receipts

• First Information Report (FIR)

• Medico-Legal Certificate (MLC)

• Duly filled CKYC form

 The purchase of  Tata AIG General Insurance Company Limited products by BAJAJ FINSERV DIRECT LIMITED customers is purely on a voluntary basis. For clarifications, customers can call on 1800 266 7780 or 1800 22 9966 or write to customersupport@tataaig.com. This information is given by BAJAJ FINSERV DIRECT LIMITED whose registered office is at Fourth floor, B2, Cerebrum IT Park, Captain Sopanrao Trimbakrao Mulik Path, Kalyani Nagar, Pune, Pune, Maharashtra, 411014. BAJAJ FINSERV DIRECT LIMITED is a Licensed Corporate Agent (Mention License no CA0551) of Tata AIG General Insurance Company Limited (IRDA of India Registration no. 108 CIN: U85110MH2000PLC128425). The insurance products are underwritten by Tata AIG General Insurance Company Limited. Bajaj Finserv Direct Limited is a registered corporate agent of Tata AIG General Insurance Limited For Bajaj Finserv Direct Limited, IRDAI Registration Number CA0551.