Liberty Health Insurance Claim Settlement

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 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%.