Bharti AXA Health Insurance Claims Procedure

Claiming the health insurance from Bharti AXA is a simple hassle free process and provides for both Cashless claims and reimbursement claims. The Bharti AXA health insurance prides itself on their claims ratio and offers great incentives such as lump sum compensation that covers hospitalization expenses. The claims are further bolstered with the fact that Bharti AXA has a tie-up with the four main TPA’s which are E-Meditek, Paramount, MediAssist and Family Health Plan Ltd along with a network of over 4300 hospitals that cater to

Incurred Claims Ratio of Bharti AXA Health Insurance for the year 2016-17:

Net Earned Premium (in Crore) Net Claims Paid (in Crore) Incurred Claims Ratio (in %)
81.62 crore 62.75 crore 76.88%

Incurred Claims Ration of Bharti AXA Life Insurance for the year 2017-18:

Net Earned Premium (in Crore) Net Claims Paid (in Crore) Incurred Claims Ratio (in %)
99.79 crore 98.29 crore 98.50%

Check Incurred Claim Ratio data for all the health insurers.

Cashless Treatments:

Cashless treatments can be used for both emergency treatments and planned visits. The below information explains what one needs to do while opting either for emergency visits or planned visits.

In Case of Emergency Cashless Treatment:

  • Emergency treatment using cashless network can be done quickly and conveniently by first, locating the closest hospital on the cashless network. One can use the Hospital locator option found on Bharti AXA health insurance claims website.
  • The patient can then proceed to admission using their health card.
  • The hospital shall be required to fill up details of the cashless request form and hand it over to the insurance help desk at the hospital.
  • The TPA will then issue a letter authorising for the required coverage as per the policy to the network hospital the patient has been admitted in. The bill will be settled by Bharti AXA with the hospital directly.
  • In case a particular treatment is not covered under the patient’s health insurance policy, a letter stating these reasons will be provided.

In Case of Planned Cashless Treatment:

  • Planned visits should be filled up 4 days prior to date of visit. The patient needs to fill up the cashless request form and submit it to the insurance help desk located at the hospital
  • Bharti AXA will inform the patient and the hospital within a period of 6 hours upon receiving the claim form either through email or through SMS
  • On the day of planned admission, the patient can admit themselves using their health card ID and the letter of confirmation provided by Bharti AXA. The hospital bill will be directly settled by Bharti AXA
  • Again, in instance where a particular treatment is not covered under the policy, a rejection letter will be provided to the policyholder stating the reasons

Reimbursement of Treatment Expenses:

When the patient/policyholder needs to be admitted or treated in a hospital outside the Bharti AXA network, the claims team needs to be intimated within 48 hours of being admitted. Claim intimations can be done on the claim form found on the website which is 1800-103-2292. This number is a toll free number. Patents/policyholders can also send a CLAIM SMS to 5667700. Alternatively they can email the claim details to which is also located in the claim form. Treatment and payment of subsequent hospital bills can be made by the patient or policyholder and the original documents from the hospital pertaining to the treatment and expenses needs to be submitted along with the claim form to the aforementioned email address.

Documents required include discharge summary of the hospital along with the final bill of the hospital. Also required would be documents pertaining to pre and post hospitalization test reports and receipts for the same along with a medical fitness certificate, prescription certificate, complete and signed claim form with supporting evidence such as attending doctor’s prescription.

Once all required documents are submitted payment will be processed and released within 21 working days. In an event of the claim not being covered under a particular policy a rejection letter stating the reasons will be provided.

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