TatvaPlus
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Term Insurance
What is Term Insurance How to Choose Term Insurance ⭐ Term vs Life Insurance Term Insurance Calculator ⭐ Section 80C Tax Benefits Term Insurance Benefits
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Health Insurance
What is Health Insurance Health Insurance Checklist How to Choose Health Insurance ⭐ Section 80D Tax Benefits Health Insurance Benefits Critical Illness Insurance Claims Checklist
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Claims
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Why TatvaPlus Book Free Call
Claim Types

Which type of claim
do you need help with?

We support claims for both health insurance and term insurance — from first intimation to final settlement.

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Health Insurance Claims

Whether it's a planned surgery, emergency hospitalisation, or a day-care procedure — we help you navigate both cashless and reimbursement claims without paperwork nightmares.

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Cashless hospitalisation at network hospitals
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Reimbursement claims for non-network hospitals
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Day-care procedure claims (cataract, dialysis etc.)
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Pre & post-hospitalisation expense claims
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Critical illness lump-sum claims
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Term Insurance Claims

Filing a term insurance death benefit claim is one of the most sensitive processes in insurance. We guide families through it with care, clarity, and end-to-end document support.

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Death benefit claim for nominee
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Accidental death benefit claims
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Terminal illness early payout claims
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Waiver of premium claim (disability)
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Nominee assistance and follow-up
Step-by-Step Process

How to file a health
insurance claim

Follow these steps exactly to avoid delays and rejections.

Cashless Claim
1
Inform the insurer
Call the insurer's helpline within 24–48 hours of hospitalisation (or before, for planned procedures). Get a pre-authorisation number.
⏰ Planned: 3–4 days before admission
2
Submit pre-auth form
The hospital's TPA desk submits the pre-authorisation form to the insurer on your behalf. Ensure all doctor details and diagnosis are accurate.
3
Insurer approves treatment
The insurer reviews and approves the estimated treatment cost. Any amount beyond the approved limit must be paid by you.
✅ Keep all original bills
4
Discharge & settlement
At discharge, the hospital bills the insurer directly. You only pay any co-payment, deductible, or non-covered items.
Reimbursement Claim
1
Intimate the insurer
Notify the insurer within the intimation period (usually 24–72 hours for emergencies; before for planned). Keep your policy number handy.
2
Pay & collect all documents
Pay hospital bills yourself. Collect all original documents — discharge summary, bills, prescriptions, diagnostic reports, and payment receipts.
📁 Keep originals safe
3
Submit claim form + documents
Submit the duly filled claim form with all supporting documents within 30 days of discharge (check your policy for exact timelines).
4
Follow up for settlement
Insurers must settle or reject within 30 days of receiving all documents. Follow up regularly and respond promptly to any queries.
⚡ TatvaPlus follows up on your behalf
Document Checklist

Documents you need
for each claim type

Missing even one document is the most common reason for claim delays. Use this checklist before submitting.

🏥 Health Insurance Claim
Duly filled and signed claim form
Original hospital bills and receipts
Discharge summary with diagnosis and treatment details
Doctor's prescription and consultation notes
All investigation / lab reports (blood, scan, X-ray)
Pharmacy bills (with prescription)
Indoor case papers (for hospitalisation claims)
Photo ID proof of patient
Original policy document (or soft copy)
Cancelled cheque / bank account details for reimbursement
🛡️ Term Insurance Death Claim
Duly filled claim intimation / death claim form
Original policy document
Death certificate (original + attested copies)
Nominee's photo ID and address proof
Nominee's bank account details + cancelled cheque
Medical records (if death due to illness)
Post-mortem report + FIR (if accidental death)
Hospital records (if hospitalised before death)
Age proof of the life insured
NEFT / bank mandate form for claim payment

TatvaPlus tip: Always keep photocopies of every document before submitting originals. For term insurance claims, ask the insurer for a written acknowledgment of your submission with a reference number.

Why Claims Get Rejected

The most common reasons
claims are rejected — and how to avoid them

Knowing what goes wrong is half the battle. Here are the top 6 reasons insurers reject claims.

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Late Intimation
Failing to inform the insurer within the required timeframe (usually 24–72 hours for emergencies) is one of the most avoidable reasons for rejection.
✓ Intimate within 24 hours always
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Missing Documents
Incomplete submission — missing original bills, no discharge summary, or absent investigation reports — leads to automatic delays or rejections.
✓ Use our document checklist above
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Non-Disclosure at Purchase
If you did not disclose a pre-existing illness or habit (smoking, alcohol) when buying the policy, the insurer can reject claims related to those conditions.
✓ Always disclose everything honestly
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Waiting Period Claims
Claiming for a condition that falls under the waiting period (usually 2–4 years for pre-existing diseases or specific illnesses) will be rejected.
✓ Know your waiting period clauses
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Non-Covered Treatments
Cosmetic procedures, dental work (without accident), or treatments listed under policy exclusions are not payable — even if medically necessary.
✓ Read your exclusion list carefully
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OPD Without Cover
Standard health plans cover only hospitalisation (24+ hours). OPD consultations, pharmacy bills without hospitalisation, and outpatient tests are usually excluded.
✓ Buy an OPD rider if needed
How TatvaPlus Helps

What we do for you
during a claim

Filing a claim alone can feel overwhelming. TatvaPlus acts as your guide and advocate throughout the process.

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Document Preparation
We help you compile, organise, and verify every document before submission — so nothing is missing.
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Insurer Follow-Up
We liaise with the insurer or TPA on your behalf to track status, respond to queries, and push for timely settlement.
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Dispute Resolution
If a valid claim is rejected or underpaid, we help you escalate to the insurer's grievance team and IRDAI if needed.
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Nominee Support
For term insurance death claims, we provide compassionate, step-by-step support to help nominees navigate the process.
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Timeline Tracking
We track every deadline — intimation, submission, query response, and settlement — so you never miss a critical date.
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Always Free
Our claims support is completely free of charge. We believe getting what you paid for should never come at an additional cost.
Need help with
a claim right now?

Don't navigate the claims process alone. Talk to a TatvaPlus expert — we'll guide you through every step, at no cost to you.

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