Travel Insurance Claims

Travel Insurance Claims FAQ's

What is the Claim Procedure?
Once the insured member requires treatment, then the Assistance company needs to be informed while quoting the Policy/Certificate of Insurance (COI) number, which is printed on the COI.

• For a Cashless claim, the Assistance Company/Insurance provider will issue an authorisation (Guarantee of Payment, GOP) to the hospital for the admissible medical expenses and the insured will need to pay the deductible and other non-admissible expenses to the hospital, while being discharged.
• For a Reimbursement claim, the insured member will need to settle the hospital bills and submit the same along with a claim form to the insurance company for reimbursement. Reimbursement will be as per policy terms and conditions, which normally happens in 7-15 days, subject to submission of all required documents.

Who can register claim in case the insured is hospitalised?
Claim can be registered by calling the TPA on Toll Free No, mentioned on the Certificate of Insurance (COI), by anyone who is accompanying the insured person who is being hospitalised or needs any other assistance.

Do I necessarily have to contact the assistance company in case of an emergency?
Yes, it is preferable to contact the Assistance Provider abroad (TPA) while seeking admission to any hospital for treatment…the network of hospitals managed by the TPA will provide standard medical treatment at affordable costs to the insured. However in the case of a medical emergency, the insured can get admitted to any hospital closest to them for immediate attention.

What are Cashless & Reimbursement Claims?
All the Inpatient (IPD) medical claims, subject to admissibility, will be considered under Cashless category, subject to the insured’s hospitalisation for a minimum 24 hours. All other claims like Outpatient (OPD) treatment, and non-medical claims like Passport Loss, Baggage Loss or Delay, Trip Cancellation / Interruption etc will be considered under Reimbursement category.

If I make the payment will I get a reimbursement?
Yes, any admissible claim in accordance with the policy terms & conditions, will be eligible for reimbursement after the insured traveller has submitted the requisite supporting documents to the insurance provide/ assistance company while abroad or on their return to India. The insured should remember to retain all the hospital bills and receipts and submit them to the company, along with the claim form to get a reimbursement.

Who will pay for the claim bills?
The Assistance Provider (TPA) or the Insurance company will settle the approved and admissible claim amount directly to with the hospital after deducting any deductible / Co-Pay / Sublimit against the policy. This deductible, co-pay etc will need to be settled by the insured traveller to the hospital at the time of discharge.

How do I report a claim?
Once the insured member requires treatment, then the Assistance company needs to be informed immediately. All the insured/insured’s family member needs to do is to reach out to the Assistance Company, on the Toll Free/Toll number, which is printed on the COI while quoting the Policy/Certificate of Insurance (COI) number. The Assistance Provider / Insurance Company will provide a Claims Reference number for future correspondence.

Where can one get the claims form for filing a claim?
Claim forms are easily available on request from the Overseas Assistance Service Providers, on the website of Insurance Company, or by reaching out to the InstantCover/EIndia customer support team on 0091 80 41101026.

Will my claim be rejected if I don’t submit relevant claims documents?
Yes, All the claims are approved after receiving complete set of required documents and as per the terms and conditions of the policy. Submission of partial documents may result in part settlement or non-settlement of the claim.

How does the insured member know if Cashless request has been approved or rejected?
The Insurance company or its Assistance Provider shall process the request for Cashless treatment after having obtained the complete information in respect of the claim from the hospital. The Insurance company or its Assistance Provider (TPA) shall provide a Guarantee of Payment (GOP)) to the hospital if the claim is admissible and approved. Hence the insured will become aware of the approval of the claim. If the claim is to be rejected because it is not admissible, then the rejection will be confirmed to the insured member accordingly.

Are there any restrictions on the hospital where the treatment should be taken?
There are no restrictions on the hospital where treatment should be taken whilst abroad in the case of a medical emergency…however in the case of a planned hospitalisation, it is preferable to approach the Assistance Provider (TPA), who will direct the insured to a network hospital.