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Edelweiss Health Insurance Claim

Edelweiss General Insurance is one of the leading insurance providers that is devoted to settling claims as per the policy terms and conditions. Be it for a planned or emergency hospitalization situation, the claims are authorized in a blink of an eye as the company has connections with multiple network hospitals. They accept all insurance claims, including cashless and reimbursement ones. It’s one of the company’s beliefs to provide maximum comfort and convenience to its customers and one of the ways it makes it happen is through a smooth health insurance claim process.

How Can a Policy Holder File An Edelweiss Health Insurance Claim?

Though Edelweiss cashless claims can only be made in-network hospitals, you are free to file reimbursement claims if you take treatments in-network or non-network hospitals. However, there are a few steps that need to be followed to get the cashless and reimbursement claim. So keep reading the next part to discover them in detail.

Cashless Claim Settlement Process

  • In order to get the claim for cashless treatment, you have to first hunt for a network hospital in your city. You can also choose to visit the official website to find out about the list of Edelweiss-linked network hospitals.
  • After that, make sure to inform the insurance company in case of emergency hospitalisation. It is suggested to notify them within 48 hours. But in the case of planned hospitalisation, make sure to inform the insurance provider before 72 hours.
  • Now in this step, you need to fill out the hospital’s pre-authorization request form. Then submit it to the support desk present in the hospital.
  • In the last step, the hospital would send the documents to the insurance provider where you need to wait for their approval. Once the documents are verified, the company approves and pays the bills of the hospital.

Reimbursement Claim

  • You need to inform Edelweiss General insurance immediately both in the case of planned and emergency hospitalisation. However, the time considered in case of emergency hospitalization is 48 hours and 72 hours in the case of planned hospitalisation.
  • You need to collect the discharge summary alongside other documents like hospital bills, invoices, medical reports and more. It is important to ensure that all the documents are hospital sealed.
  • Now fill up the “claim form” and sign it which you can easily get from the official website of Edelweiss general insurance.
  • Make sure to attach a photo ID and cashless card alongside other required documents to the insurance provider’s address.
  • In this step, you need to wait for the claim to get reviewed and receive the approval as per the policy terms and limitation

Documents Required To Make Edelweiss Health Insurance Claim

There are a number of documents which you must keep close while making a claim for the reimbursement treatment. These documents include

  • Investigation report
  • Hospital discharge summary
  • Pharmacy bills including the prescription
  • Discharge report
  • Indoor case paper
  • Duty filled claim form
  • FIR and post mortem report if present
  • Original bills and receipts
  • Original hospital bill and consultation note
  • Test reports
  • Surgeons bill
  • Doctor’s report
  • Cancelled cheque with bank account details

Checking The Status of Edelweiss Health Insurance Claim

If you want to check the status of the submitted claim, then all you need to do is follow the steps given below.

  • Visit the official website of the Edelweiss health insurance.
  • After that, click on the ‘Lodge a claim button’ and then select the ‘track claim status’.
  • Now submit all the required details including customer ID, policy number, claim number and others.
  • Lastly, click on the ‘submit’ button to review the status.

You can also contact the insurance provider by emailing them at support@edelweissinsurance.com to check the claim status. The insurance provider has a great customer support team who would assist you with every query within a few minutes.

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