Health Insurance Reimbursement Claim (Part A & Part B)
स्वास्थ्य बीमा प्रतिपूर्ति दावा प्रपत्र (भाग अ एवं भाग ब)
Official claim form submitted by policyholder and hospital to reimburse hospitalization, surgery, and medicine costs.
Documents required (आवश्यक दस्तावेज)
- Discharge Summary with detailed diagnosis
- Final Itemized Hospital Bill with Breakup
- Original Payment Receipts & Advance Receipts
- Investigation Reports (X-Ray, Blood, MRI)
- Doctor's Prescription for medicines
Key details
- Authority: Third Party Administrator (TPA) / General Insurance Company
- Stamp paper / fee: Policyholder & Hospital Authorized Signatures
- How to submit: Online via TPA Mobile App or Physical courier to TPA Office within 15–30 days
- Processing time: 15–21 Days for settlement
- Official portal: https://irdai.gov.in