Reimbursement Claims Process

A reimbursement claim is filed after you've paid the hospital bill yourself. It's the fallback when the hospital isn't on your insurer's network — or when the cashless request gets rejected.

Documents you'll need

• Filled claim form, signed by the insured.
• Original hospital discharge summary.
• Itemized hospital bills with payment receipts.
• All prescriptions, diagnostic reports, and investigation reports.
• Doctor's first consultation note and final diagnosis.
• Pharmacy bills with the corresponding prescriptions.
• Photo ID, policy copy, and a cancelled cheque for direct credit.

Timeline

Submit within the timeframe printed on your policy — usually 15 to 30 days from discharge. Insurers then have an IRDAI-defined service window to settle or query, typically 30 days.

How to maximise your settlement

• Keep originals — most insurers won't accept photocopies for first submission.
• Group documents in the order printed on the claim form.
• Respond to insurer queries within 7 days — extended silence can lead to claim closure.
• If partially denied, write to the insurer's grievance officer before going to IRDAI's IGMS portal.