health insurance claim

udayan

Member
Messages
474
ok i need quick advice for new india assurance medical insurance

my bhabhi is going to be hospitalised in yashoda hospital ghaziabad because of some ailment , my brother has new india assurance medical insurance for many years now , but will avail its befits 1st time today .

brother has insurance of 3 lac rs , his son has 1 lac and his wife (bhabhi) has of 1 lac rs .

what are the advice/procedures for us for hassel free cashless experience at hospital .

need it quick as she will be hospitalized in a couple of hours
 

bhojv74

Regular
Messages
614
ISP
Airtel
Usually, just inform the hospital at the time of getting admitted that it will be cashless. Carry your NIA cashless ID card and insurance papers, they would need a xerox of the same.

Also inform the doctor that it will be under insurance, so that he covers all the points in his prescription.

If you got the insurance through an advisor, inform him so that he will follow up with the company to get the cashless authorization. Even if you do not do this, you are fine.
 
Messages
141
ISP
dna ifotel
also inform insurance company about the same.. and also make sure they have tie up with the hospital to avail cashless facility.
 


bhojv74

Regular
Messages
614
ISP
Airtel
NIA usually gives a list of hospitals that they have tied up with. I believe you have already checked with the list or the hospital.

after 24 hrs of filing for cashless, you may call on 9674747272 (NIA) phone number to find out the status of your claim. This number works for me in Kolkata, your region may have a different number, find it out from your advisor.
 

udayan

Member
Messages
474
Yes hospital is obviously listed

Only problem is that agent says that we have to get a general /normal room as our policy amount for patient is only 1 lac and only normal room is allowed in this category, if we get a better room then our claim won't be accepted

Didn't know this before or we would have gone for more amount or policy with better room /services
 

bhojv74

Regular
Messages
614
ISP
Airtel
I think he is partially correct, 1L policy will only provide for a lower grade room, but if you choose a higher grade you would have to pay the difference. Check with him again, or check with the hospital.
 


Messages
141
ISP
dna ifotel
check the limit for rooms on your policy fine print.. it would be 1% of sum insured (for 1 lacs 1000 INR only)
so even if u selected normal room make sure it not exceed rs 1000..cross check with ur agent
 

bhojv74

Regular
Messages
614
ISP
Airtel
Again, you can exceed the limit, but you will have to pay the difference.

Since you have an old policy, you must have accumulated bonus. Bonus can be used for hospital packages but not add ons like medicines or any equipment etc. I suggest go for a packaged treatment from the hospital if it is available.
 
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