Health Insurance Claims Online | How to claim health insurance online ?

Reliance General Insurance

Four Easy Steps to File Your Claim

We aim to make the claim process as smooth as possible for your convenience. Here's how to go about it:

Step 1: Doctor advises hospitalisation (or treatment).

Step 2: Intimate your claim (as soon as it occurs).

Step 3: CASHLESS CLAIM - Visit Network Hospital for the treatment.
REIMBURSEMENT CLAIM - Undergo your treatment at the Non-network Hospital and make the payment.

Step 4: CASHLESS CLAIM - Hospital's TPA Desk contacts us for arranging cashless treatment.
REIMBURSEMENT CLAIM - Submit your documents within 15 days of discharge for reimbursement.

For the flowchart of claim process, click here

Claim Intimation:

To make your claim process fast and smooth, we serve our health insurance customers through RCare Health (our in-house health claims unit). We also have appointed a Third Party Administrator (TPA) desk duly licensed by IRDA for the same.

To file health insurance claim request, Insured/Claimant can contact on numbers mentioned on the Health Card / Policy Schedule.

Information to be kept ready while intimating the claim:

Policy Number
Insured/Claimant contact details (phone no. , email id, address, landmark etc.)
Name of Insured/ claimant person, who is hospitalised
Relationship of insured with the person who is hospitalised.
Name of the hospital
Nature of ailment-(For health claims)
Nature of accident- (For accident cases)
Date & time of accident (For accident cases)
Location of accident (For accident cases)
Commencement date of the symptom of ailment

A walk through the claim process:

Claim process for Cashless facility:

Get admitted in any one of Reliance General Insurance Network Hospitals
Flash the Reliance Health Card at TPA helpdesk of hospital
Fill "Cashless Request Form" (available in all the network hospitals at TPA desk)
Submit the authorisation form, along with a copy of the health card to the hospital at the time of admission (ensure to have a photo ID at this time)
Await authorisation from the hospital (the hospital co-ordinates with the RCare Health /TPA for this)
Hospital Fax/Email the pre-authorisation form to the RCare Health /TPA along with necessary medical details
Insured/ Claimant verify and sign all the bills
Leave the original discharge summary and other investigation reports with the hospital
Retain a photocopy for your records

Claim process if ‘cashless hospitalisation’ is denied by RCare Health/TPA:

Settle the hospital bills in full as required
Collect all the original bill documents and reports at the time of discharge
Lodge your claim with RCare Health /TPA for processing and reimbursement

Claim process for emergency hospitalisation with ‘cashless facility’:

Get admitted into the hospital
Obtain the pre-authorisation form from hospital
Get the form filled in and signed by the attending doctor
Hospital Fax/Email the pre-authorisation form to the RCare Health /TPA along with necessary medical details
Insured/ Claimant verify and sign all the bills
Leave the original discharge summary and other investigation reports with the hospital
Retain a photocopy for your records

Please note that at the time of discharge, you will be required to pay for expenses that are not payable as per the terms and condition of the policy.

Claim process for planned hospitalisation with ‘cashless facility’:

Co-ordinate with your doctor and the hospital and send all the details about the planned hospitalisation to RCare Health /TPA, two days before your hospitalisation(including the plan of treatment, cost estimates etc)
Present the authorisation letter and photo ID card to the hospital at the time of admission
Hospital Fax/Email the pre-authorisation form to the RCare Health /TPA along with necessary medical details
Insured/ Claimant verify and sign all the bills
Leave the original discharge summary and other investigation reports with the hospital
Retain a photocopy for your records

Please note that, at the time of discharge, you will be required to pay for expenses that are not payable as per the terms of the policy.

Claim process for emergency hospitalisation with ‘reimbursement facility’:

Get admitted into the hospital
Intimate the claim at RCare Health call centre/E-mail as soon as possible
Settle the hospital bills in full as required
Collect all the original bills, documents and reports at the time of discharge
Lodge your claim with RCare Health /TPA for processing and reimbursement, by filling in the claim form and attaching required documents as mentioned in the claim form

Claim process for planned hospitalisation with ‘reimbursement facility’:

Intimate RCare Health /TPA of the planned hospitalisation
Get admitted into the hospital
Settle the hospital bills in full as required
Collect all the original bills, documents and reports at the time of discharge
Lodge your claim with RCare Health /TPA for processing and reimbursement