Claim Settlement of Liberty Health Insurance
Liberty General Insurance (LGI) is committed to offering quick and hassle-free claims process with the help of its appointed Vipul Med Corp TPA. With almost 4,000+ hospitals in its network, the company settles claims as per the policy wording. LGI is not just focused on settling claims at the earliest, but also guiding customers and standing by their side at times when they need any help from them. You can get your claim settled either through the cashless procedure or through the reimbursement procedure.
Claim Process for Cashless Treatment
You can avail cashless procedure benefits by getting treatment at network hospitals of Liberty General Insurance. In this process, you don’t need to make any payment related to medical expenses as the insurer pays your bills. Here are expert guides to file a cashless claim:
- Approach to one of the network hospitals in your city
- Intimate TPA at least 48 hours before a planned hospitalisation
- Inform the TPA within 24 hours after hospitalisation in case of an emergency situation
- Carry your ‘Liberty Health Card’ or share your ‘Policy number' and a valid photo ID with the hospital
- Get the pre-authorization request form available at the hospital. Fill it and submit it to the hospital
- After checking your identity, the hospital/TPA sends the form to the Liberty General Insurance
- LGI evaluates the documents and classifies the case as Authorised, Queried or Denied
- They provide the confirmation to the Network Hospital by e-mail and also send a text message and an e-mail confirming the same to you
- Then, they settle the claim (as per policy terms & conditions) with the hospital
You need to go for the reimbursement claim procedure if you get treatment at a hospital, which is not part of the insurer’s network. In this case, you settle the medical treatment bills with the hospital and then file a reimbursement claim with TPA. Here is the complete process of reimbursement claims.
- Intimate TPA at least 48 hours before the planned hospitalisation
- In an emergency situation, intimate the TPA 24 hours after hospitalisation
- Get the treatment at the hospital of your choice and settle all the bills
- Collect original medical bills, examination reports, receipts, pharmacy store bills, etc. at the time of discharge
- Get the reimbursement claim form from the official website of LGI and fill it
- Send all the documents by post or courier within a maximum of 15 days to the TPA
- LGI accesses the claim reports and may ask for more records if required
- After verifying all the details, the claim is either approved or declined
- In case of approval, the claim amount is transferred to your bank account
Below is the list of indicative documents to be submitted in case of a reimbursement claim.
- Duly completed claim form
- Medical case history/summary
- Original investigation reports and bills
- Original receipt and discharge summary
- Original cash memos from hospital(s)/chemist(s)
- Pharmacy bills along with the proper prescriptions
- Medical practitioner/surgeon’s original bill and receipt
- Original bills & receipts for claiming ambulance charges
- The surgeon’s certificate stating the nature of operation performed
- Certificate of the attending doctor/consultant/anesthetist regarding diagnosis
- Other reports or pathological tests supported by surgeon demanding such pathological tests
- Any other documents, as may be necessary by the Company or TPA
If you have any doubt, feel free to talk to InsuranceDekho at 1800-1205-698.
Incurred Claim Ratio (ICR) of Liberty Health Insurance
Incurred Claims Ratio plays a pivotal role when it comes to shortlisting a health insurance policy. It is an indication of the insurer’s ability whether or not they can settle the claims. Insurance Regulatory and Development Authority (IRDAI) publishes data of ICR in its annual report. According to IRDAI 2017-2018 report, the ICR of Liberty General Insurance is 82%.