Go Digit Health Insurance Claim Settlement

Go Digit Health Insurance

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5,900+ Network Hospitals

865 policies issued

11% Incurred Claim Ratio

Lifelong Renewability

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Dedicated Claim Settlement

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Claim Settlement of Go Digit Health Insurance

GoDigit General Insurance is a growing health insurance company, which offers hassle-free health claim procedures. With a network of 1,500 strategic partners that include brokers, dealers, etc. in almost 70 cities, the insurer has established a smooth claim settlement procedure in the country. GoDigit is committed to ensuring a quick and fast claim procedure through its dedicated TPA service provider. You can get your claim settled with the cashless facility or reimbursement option. 

  • Claim Process for Cashless Treatment

    Cashless facility is available at network hospitals only. This is facilitated by the TPA service provider of GoDigit. The company pays directly to the network hospital so you can get cashless treatment. Here are step-by-step guides for cashless claims:

    • Look for a hospital in a city which is in the network of GoDigit
    • Inform GoDigit about hospitalisation within 24 hours in an emergency case and within 72 hours before any planned hospitalization
    • Share the health card or copy of E-cards with ID proof with the hospital authority
    • Obtain the pre-authorization form from the hospital
    • Fill and sign the form and submit it at the hospital’s helpdesk counter
    • Make sure the hospital shares the form with TPA/service provider
    • TPA makes decisions and informs the hospital directly depending on the policy terms and conditions
    • Once the request for pre-authorization is granted, ensure that the treatment takes place within 15 days of the pre-authorization approval date or before the policy expiry date
    • GoDigit can add, modify or restrict network provider for cashless facility at its sole discretion
    • Please check the applicable updated list of network providers
  • Reimbursement Treatment

    You can avail the reimbursement facility from any hospital within India. In this case, you need to make payment directly to the hospital and claim for reimbursement. Follow the below-mentioned steps for the reimbursement process:

    • Intimate GoDigit or its Service Provider/TPA within 48 hours of the date of admission
    • Submit all original documents within 30 days of the date of discharge
    • After receiving the documents, the insurer investigates and makes sure if there is no alleged injury or illness
    • Claims are settled within 30 days from the date of receipt of the last necessary document
    • In case of any delay in payment, the insurer pays interest at a rate which is 2% above the bank rate
    • If the insured member dies, the claim amount is reimbursed to the nominee as named in the policy schedule
  • Documents Needed

    Here is a list of documents required for the reimbursement claim settlement procedure:

    • Duly filled and signed claim form
    • Discharge summary and investigation reports
    • Medical Records (Indoor Case Papers, OT Notes, PAC Notes, etc.)
    • Original hospital main bill and pharmacy bill
    • Original hospital bill break-up and consultation papers
    • Prescriptions for the medicines purchased (except hospital supply) and investigations done outside the hospital
    • Digital images/CDs of the investigation procedures (if required)
    • Original invoice/sticker, post mortem report, disability certificate, etc.
    • Attending physician’s certificate, birth discharge summary, bank details with cancelled cheque
  • Incurred Claim Ratio (ICR) of Go Digit Health Insurance

    Incurred Claims Ratio (ICR) allows one to gauge the potential of an insurance company. It lets you know the speed of the claim procedure and productivity in terms of profit earning. GoDigit’s ICR is 11%. 

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