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Availing of the Services

Visit any hospital of your choice, either one in your network or one outside your network. If you opt for one that is within your network you get the benefit of ‘Cashless Services’ while incase of a non-network hospital, you have to settle the bills and claim reimbursement.

Claim Procedures

    Hospitalisation in Network Hospitals
   Emergency
 Step 1 Get admitted into the hospital by producing your Health ID card, photo ID and age proof to the hospital. (Refer to the list of photo ID's and age proof documents accepted by TPA below).
 Step 2 As soon as possible, inform the TPA and coordinate with the hospital to have the details sent to the TPA, for authorisation for cashless service.
 Step 3  
A)  
In case of a very short stay at the hospital or if the authorisation for “Cashless Service” was not received from the TPA or if “Cashless Service” was denied by the TPA
At the time of discharge, settle the hospital bills in full and collect all the bills, documents and reports.
Lodge your claim with the TPA for processing and reimbursement.
OR  
B)  
If authorisation for “Cashless Service” from the TPA has been received at the time of discharge
Verify the bills and sign on all the bills and the authorisation letter.
Pay for bill amount exceeding the product benefit amount paid by us.
Leave a copy of the discharge summary and other investigations reports with the hospital.
Sign the Claim Form.
   Planned
 Step 1 Please coordinate with your doctor and the hospital and send in all the details of your planned hospitalisation.
This includes the plan of treatment, cost estimates, photocopy of Health ID card, photo ID and age proof (Refer
to the list of photo IDs and age proof documents accepted by TPA below). Also mention the address or fax
number where the authorisation is to be sent along with the mobile no. to receive updates on your claims
and authorisations. This should be sent to the TPA at least seven days prior to the admission (see pre and post–hospitalisation extension benefit).
A)  
If authorisation for “Cashless Service” from the TPA has been received by you
At the time of admission, hand in the authorisation letter and a photocopy of your Health ID card and a photo ID to the hospital.
At the time of discharge:
  a) Verify the bills and sign on all the bills
  b) Pay for bill amount exceeding the product benefit amount paid by us.
  c) Leave a copy of discharge summary and other investigations reports with the hospital.
  d) Sign the Claim Form
OR  
B)  
In case “Cashless Service” was denied by the TPA
At the time of discharge, settle the hospital bills in full and collect all the bills, documents, reports and Payment Receipt.
Lodge your claim with our TPA for processing and reimbursement.
 
    Hospitalisation in Non-Network Hospitals
Emergency
 Step 1 Get admitted into the hospital.
 Step 2 As soon as possible, inform TPA about the hospitalisation.
 Step 3 At the time of discharge, settle the hospital bills in full and collect all the bills, documents and reports.
 Step 4 Lodge your claim with our TPA for processing and reimbursement along with a photocopy of your Health ID card, photo ID and age proof (Refer to the list of photo IDs and age proof documents accepted by TPA below).
Planned
 Step 1 Inform TPA about the planned hospitalisation seven days prior to the admission (see pre- and post–hospitalisation extension benefit).
 Step 2 Get admitted into the hospital.
 Step 3 At the time of discharge, settle the hospital bills in full and collect all the bills, documents and reports.
 Step 4 Lodge your claim with our TPA for processing and reimbursement along with a photocopy of your Health ID card, photo ID and age proof (Refer to the list of photo IDs and age proof documents accepted by TPA below).
 
Lodging a claim for processing and reimbursement
Within 21 days after discharge, please lodge your claim with our TPA for processing. Send the filled and signed Claim Form. You can download the Claim Form from our or TPA’s website www.paramounttpa.com/aegonreligare. When lodging your claim with our TPA, please make sure that all the documents listed below are submitted. The following documents are required for the processing of the claim for different kinds of expenses.
Check list of enclosures for submission of claims
1. Duly attested discharge card
2. Copy of Health ID card duly certified by the treating doctor/hospital
3. Photo copy of age proof and photo ID proof (Refer to the list of photo IDs and age proof documents accepted by TPA below).
4. Copies of hospital bills (duly attested)
5. Break up details of the bill
6. If package treatment, break up details of package bill
7. Copies of investigation reports, lab reports (duly attested)
8. Pharmacy bills supported by prescription
9. Claim form duly filled in bearing the signature of the Policyholder
List of documents accepted for Photo ID and Age proof
Key Definitions
 

Third Party Administrator (TPA) contact for claims

Our Partner Paramount Health Services (TPA) Pvt.Ltd. will assist you in providing all the information you may
need to ensure that you have a hassle free claim experience.
Toll - Free Number: 1800226655 (for MTNL, BSNL, & TATA users - Pan India & for Vodafone & Airtel users of Mumbai & Delhi) (Service 24 Hours, 7 days a week)
Help Line no. 022-66620 808 (Serviced 24 Hours, 7 days a week).
Website: www.paramounttpa.com/aegonreligare
Email id: contact.phs@paramounttpa.com
 
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© Copyright AEGON Religare 2007,
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Insurance is the subject matter of solicitation. AEGON Religare Life Insurance Company Limited Registration No. 138 For more details and term and conditions, please read the sales brochure carefully before concluding a sale. UIN No.: 138N021V01; ADVT NO.: II/June 2010/686 This is a non participating traditional plan.
Registered office:AEGON Religare Life Insurance,2nd Floor, Paranjpe B Scheme, Subhash Road, Near Garware House,Vile Parle (E),
Mumbai - 400 057.
Tax benefits are as per the Income Tax Act, 1961, and are subject to amendments made thereto from time to time.
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