Digit Health Insurance Claim Settlement

You can avail of the reimbursement facility from any hospital within India. In this case, you need to make payment directly to the network 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 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

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 supplies) 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 canceled cheque

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. Go Digit health insurance claim settlement ratio for FY 2018-19 is 11%.