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IFFCO Tokio Health Insurance Claim Settlement

IFFCO Tokio Health Insurance, a pioneer in the health insurance industry, is dedicated to offering hassle-free health claim procedures. With a huge network of around 4,200 network hospitals, the insurer ensures a smooth claim settlement procedure across the nation according to its regulations. IFFCO Tokio is widely appreciated for its easy and fast cashless claim procedure either through external TPAs or directly by IFFCO Tokio. The policyholders can get their claims settled with a reimbursement option or a cashless facility.

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  • Claim Process for Cashless Treatment

    Cashless claims can be availed at the network hospitals of IFFCO Tokio only. Currently, the insurer is impaneled with 4,200+ hospitals. However, here is a guide to filing a cashless claim with IFFCO Tokio:

    • Search for a hospital tied up with IFFCO Tokio, where you would like to avail cashless treatment
    • Inform the Third Party Administrator (TPA) as soon as you get hospitalised in the case of emergency hospitalisation, while within 3 days before the hospitalisation in the case of planned admission. 
    • Find a cashless request form from the hospital’s help desk, fill it and send it with relevant medical records to the TPA  
    • The TPA will inform the hospitals about its decision, which may include the approval of the claim or a request for additional documents
    • If TPA grants the approval for a cashless claim, medical bills will be settled directly as per the policy offerings 
    • If the claim gets rejected by the TPA, the policyholder will have to settle the bill with the hospital on its own and later can request the reimbursement process as per the terms and conditions

    How to Check Iffco Tokio Health Insurance Plan Claim Status

    To track your claim status, you can either follow the online method or the offline method.

    Online Procedure

    To check the status of your claim online, you can simply follow the given steps:

    • Go to the official website of Iffco Tokio and select the ‘Claim’ section from there.
    • Next, on the claim status portal, enter the details as required such as Policy No, Claim No, and search number.
    • Click on ‘Submit’. You can check your claim status from the displayed web page.

    Offline Procedure

    You can also check your claim status offline mode by visiting the nearest branch of Iffco Tokio Health Insurance Company and providing the necessary details to the customer care representative there. Also, you can simply call them at their helpline number 1800-103-5499. They may ask you for your policy number or claim number to update you regarding the status of your claim.

  • Reimbursement Treatment

    In case, someone couldn’t avail of the cashless treatment facility at the network hospital due to any reason or had to get treated at a non-network hospital; then a reimbursement claim settlement procedure comes into force. Here is the process for it:

    • Convey about the hospitalisation to IFFCO-Tokio just after the hospitalisation but not later than 7 days of discharge
    • While informing do quote your Policy Certificate Number
    • Opt for medical treatment or procedure and avail it
    • Pay the bills at the hospital and file the reimbursement claim.
    • Download the reimbursement claim form from the insurer’s website
    • Collect all the supporting documents such as medical reports, invoices, ID proof, and so on at the time of discharge and submit it along with the claim form to the insurer's office

  • Documents Needed

    Following are some essential documents that are required to be submitted to claim a reimbursement. 

    • Claim form with doctor's certificate 
    • Discharge details 
    • Medical bills
    • Prescriptions for medicines
    • Final receipts
    • Test reports of diagnosis, x-ray scan, ECG etc.

    However, if required, the team handling the claim process may ask for some more documents as well.

  • Incurred Claim Ratio (ICR) of IFFCO Tokio Health Insurance

    One can gauge the potential of an insurance company through Incurred Claim Ratio (ICR). It unveils the speed of the claim procedure as well as the productivity in terms of profit earning. The IFFCO Tokio General Insurance Claim Ratio for FY 2018-19 is 102%, which speaks about the efficiency of claim settlement and the stability of the insurer at the same time. 

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FAQs

  • How many claims I can make with IFFCO Tokio plan?

    There is no maximum limit for claims to be made. Thus, you can make as many claims as you need within the limit of your plan’s sum insured. 

  • Can the company reject my claim in any case?

    Yes. The company can reject your claim on various grounds as per the terms and conditions mentioned in the policy.

  • At how many hospitals is the cashless facility available?

    You can avail cashless treatment at more than 4,000 network hospitals.

  • What documents do I need to present before Iffco Tokio team to request a claim?

    Here are the documents which need to be submitted to seek a claim:

    • Duly filled claim form 
    • Certificate from the doctor
    • Discharge details
    • Medicine prescriptions
    • Medical bills
    • Final receipts from the hospital
    • Diagnosis reports such as x-ray scan, ECG, etc.

    In addition to these, the claim settlement team of Iffco Tokio may ask for some other documents as well.

  • At how many network hospitals does Iffco Tokio provide cashless claim facility to its policyholders?

    Yes. Iffco Tokio offers cashless claim facility in over 4,000 network hospitals to the policyholders.

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User Reviews

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  • Happy with Customer Service Te...

    I was really confused about which insurance to take for my family. With the help of InsuranceDekho and their good customer service team, I was able to finalise the IFFCO Tokio Family Health Protector Policy for my family.

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    A
    IFFCO Tokio
    By Ayush Kumar Singh
    On: Feb 29, 2024
  • Professional Advisors

    The insurance experts of the InsuranceDekho company are kind and professional. I like their friendly nature. They made my purchase of the IFFCO Tokio Health Insurance Plan from their online platform much easier and smoother. Thanks to the InsuranceDekho company!

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    H
    IFFCO Tokio
    By Himanshu Raghav
    On: Jan 08, 2024
  • The best policy to cover famil...

    I wanted to purchase a policy so that I can secure my family. I looked for it on the website of InsuranceDekho. I purchased a plan from Iffco Tokio. I was happy with the easy process of purchasing a plan from the InsuranceDekho  

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    S
    IFFCO Tokio
    By Shiva Raman
    On: Feb 28, 2023
  • Reminder feature

    I had purchased the IFFCO Tokio Individual Medisure plan  from the InsuranceDekho’s website. I purchased this plan because it was quite unique and provided good coverage at an affordable price. I had to renew this policy and InsuranceDekho keep sending me reminders to renew the policy on time. Thanks to InsuranceDekho, I was able to renew my policy on time without any fail.

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    M
    IFFCO Tokio
    By Mehak Ghai
    On: Feb 10, 2023
  • Great Assistance Provided

    I bought IFFCO Tokio Individual Medisure Plan from an online platform called InsuranceDekho. I am pleased with my experience buying a health insurance policy from here. The customer service won my heart with their dedication and hard work. They understood the value of time and helped me resolve the problems as quickly as possible. 

    Read More

    S
    IFFCO Tokio
    By Shivam Jain
    On: Feb 03, 2023
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