National Health Insurance Claim Settlement

To avail the cashless treatment, you are required to undergo treatment at the network hospital. 

• One can undergo treatment in a network provider/PPN, which is pre-authorised by the TPA
• Get a cashless request form from the network provider/PPN or TPA and send the completed form to the TPA for authorization
• The TPA will issue a pre-authorisation letter to the hospital after getting cashless request form and related medical information from the insured individual or network hospital or PPN and will pay for the medical and admissible expenses
• Verify and sign the discharge papers at the time of discharge and pay for non-medical and inadmissible expenses
• After receiving final documents the offer gets accepted, the due payment will be made within 7 days from the date of acceptance by the company
• The TPA holds the right to deny pre-authorisation if the insured individual is unable to provide the required medical details
• In case the cashless access gets denied, then the insured person may undergo treatment as per the doctor and later claim for reimbursement

How to Check National Insurance Health Insurance Plan Claim Status

You can check the status of your claim either through online mode or offline mode.

Online Procedure

You can check your claim status by following the steps given below:

• Go to the official website of National Insurance Company.
• Select the’ Lodge Claim’ icon at the corner of the website and click on ‘Track Claim Status’.
• Enter the details like policy no, customer ID no, claim no, date of loss etc.
• Click on ‘Submit’. You can track your claim status.

Offline Procedure

Policyholders can also track the status of their claim through offline mode. They can either visit the nearest branch of National Insurance or call their customer care executive at 1800 200 7710( Toll Free Number). Do not forget to carry all the relevant details regarding your policy for the ease in process.