Want to File a Health Insurance Claim?

Call our Helpline numbers 1800-258-5956 or Email us - healthclaims@godigit.com. We are available 24/7, even on National Holidays

Health Insurance Claims Made Simple with Digit

What is a Health Insurance Claim?

A health insurance claim is the official request and process through which you can get your healthcare and medical costs taken care of by your health insurance provider. For example; if a family member is unfortunately hospitalized due to an illness, and are covered in your health insurance plan, you will need to file for a health insurance claim to go ahead with a cashless treatment, or get a reimbursement processed for their hospitalization. 

Types of Health Insurance Claims

  • Cashless Claim - As the name suggests, a cashless claim means you don’t pay anything from your pocket if you choose to get treated at any of our network hospitals. As per your health insurance plan, your insurance provider a.k.a we will cover for your treatments. However, do keep in mind that the extent of this will depend on your plan and coverage benefits. 
  • Reimbursement Claim - A Reimbursement claim is one of most common types of health insurance claims. In this case, you can get treated at any hospital, whether it is a network hospital or not doesn’t matter. As per your health insurance plan and coverage benefits, you can apply for a reimbursement within 15 days of discharge.
  • Advance Cash Claim - A Digit special benefit, we also give you the option to get up to 50% Advance Cash for pre-approved claims. This works best for people who have a treatment, or daycare procedure planned in the coming days so you have enough time to get your claim approved and advance cash processed. The remaining 50% may be opted through reimbursement, post discharge.

How to make a Cashless Claim?

We believe in transparency, and so you know exactly what to expect during a health insurance claim we’ve put down the complete steps of going through a cashless claim that you can opt for at any of our 6400+ Network Hospitals.

Step 1: Please inform us least two to three days before any planned hospitalization or within 24 Hours of hospitalization in case of an emergency situation.

Step 2: Show your e-health card and ask for the pre-approval form at Mediassist help desk/insurance helpdesk at the hospital.

Step 3: Fill and sign the form and submit it at the helpdesk.

Step 4: If all is okay, you can go ahead with the treatment using the cashless facility. Make sure that the treatment is done within 15 days of approval.

How to make a Reimbursement Claim?

Step 1: You need to call us within two days of your admission date. Post our call, we’ll send you a link where you can upload the soft copies of all original documents (bills, reports, etc) and bank details of your desired bank account.

Step 2: Before uploading, you need to sign all the documents yourself. You also need to write ‘For Digit Insurance’ on them. Keep all originals handy as we may ask for them if required.

Step 3: Upload the documents within 30 days from the date of discharge or when you receive the link.

Step 4: We will keep you posted for any additional requirements.

Step 5: You will receive the payment within 30 days from the receipt of the last necessary claim document. 

How to get Advance Cash approved?

Step 1: Let us know about your treatment and hospitalization and the estimate for the same.

Step 2: We’ll assess the documents and if approved, we will give you 50% of the money before the treatment even begins!

Step 3: The rest of the money for the treatment can be reimbursed after all bills and documents are uploaded.

Documents Required for a Health Insurance Claim

Whether you go for a cashless claim or reimbursement, here’s an exhaustive list of documents you may need to upload or submit while making a health insurance claim. Don’t worry, the documents differ from claim to claim but this list has everything possible. You may need only a few or all of them based on your situation.

List of Documents Hospital-ization Claim Critical Illness Claim Daily Hospital Cash Claim
Duly Filled and Signed Claim form ✔ ✔ ✔
Discharge Summary ✔ × ✔
Medical Records (Optional Documents may be asked on need basis: Indoor case papers, OT notes, PAC notes etc.) ✔ ✔ ×
Original Hospital Main Bill ✔ × ×
Original Hospital Main Bill with breakup ✔ × ×
Original Pharmacy Bills with Prescriptions (except hospital supply) and investigations done outside the Hospital) ✔ × ×
Consultation & Investigation Papers ✔ ✔ ×
Digital Images/CDs of the Investigation Procedures (if required) ✔ × ×
KYC (Photo ID Card) Bank Details with Cancelled Cheque ✔ ✔ ✔
There are some more documents that will be needed only in specific cases, such as:
In case of pregnancy related claims- Ante-natal Record, Birth discharge Summary ✔ × ×
In case of an accident or involvement of police- MLC/FIR Report ✔ ✔ ×
In case of death or disability- Post Mortem Report, Death Certificate or Disability Certificate Original Invoice/Sticker (If applicable) ✔ × ×
Attending Physician Certificate (If applicable) ✔ ✔ ×

FAQs about Digit Health Insurance Claims

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