Health Claims Procedure
If you are suffering from an illness / disease or meet with an accident which requires hospitalisation, contact Future Generali Health (FGH), an In-house unit of Future Generali India Insurance Company Limited established in 2010 for servicing your health insurance policy.
It is advisable to get hospitalised in a Network hospital and undergo Cashless access. If you are not able to utilize the cashless service, pay the hospitalisation expenses and submit the bills to us for Reimbursement. Even if you are opting for Reimbursement, please note it is mandatory that you intimate us about the hospitalisation through Email / Toll Free Line / Fax.
For more details please visit Download Forms link under "Claims Tab" on our website where you will find the below mentioned documents;
While intimating the hospitalisation, you need to provide following information to us:
- Name of the Patient
- Patient’s Health ID Card Number
- Hospital Name
- Hospital address with Landmark & Pin code
- Hospital Contact No
- Name of treating doctor and contact no
- Date of admission
- Date of discharge (Expected)
- Approximate Expenses
- Illness / disease for which hospitalised and treatment details.
In case of an accident, below mentioned information need to be provided:
- Date & time of accident / loss
- Brief description of accident along with place of accident
- Name and address of police station if FIR filed
- Name of person who took insured to hospital
Cashless Claims Procedure
- To avail cashless benefit, intimate the hospitalisation through Preauthorization Request Form atleast 72 hrs prior to getting hospitalised. In case of an emergency hospitalisation, you need to intimate within 24 hrs of hospitalisation but before your discharge from the hospital.
- Hospital will check for Future Generali Health ID card and any photo identity card for the reason of identity proof.
- Get the preauthorization form filled and signed by the treating doctor, put your sign on the form and hand over to the hospital for the process.
- Hospital will stamp the form and fax / e mail it to FGH for authorization.
- FGH will process the preauthorization request and revert to hospital within 4 hours.
- For detailed Cashless Process, please refer to FGH – Cashless Claim Process available in Download Forms link under "Claims Tab"
Procedure to be followed at the time of discharge:
- Sign the final bill and check the bill for correctness.
- Ensure that all supporting documents are attached to the bill.
- You must pay all bills not associated with the condition for which hospitalization was authorized and the amounts towards non medical expenses.
- Retain a copy of the final bill and discharge summary.
- Sign a duly filled Future Generali Health Claim Form and give it to the hospital along with copy of all previous relevant consultation letters before discharge.
- Hospital will submit the claim documents to us for processing of payment.
- Intimate the hospitalisation at least 72 hrs prior to getting hospitalised. In case of an emergency hospitalisation, you need to intimate within 24 hrs of hospitalisation.
- Take the necessary treatment at the hospital and settle the hospitalisation bills.
- Before getting discharge collect all original hospital papers including discharge summary, final bill with break up, lap reports, payment receipts etc. For more details on documentation requirement please Refer FGH – Check List available in Download Forms link under "Claims Tab"
- Submit the hospitalisation documents along with duly filled claim form to us for claim processing within 15 days of discharge from the hospital.
- Claim settlement will take approximately 14 working days from the date of receipt of complete claim documents at FGH Pune.
- For detailed Reimbursement Claim Process, please refer to FGH – Reimbursement Claim Process available in Download Forms link under "Claims Tab"
Pre-hospitalisation and Post-hospitalisation Claims
- Submit the claim documents to us for processing within 7 days of completion of treatment. Claim settlement will take approximately 14 working days from the date of receipt of final documents at FGH Pune, provided all documents are in order. For more details on documentation requirement please refer FGH – Check List available in Download Forms link under "Claims Tab".