Manipal Cigna Secure Health Plan

If you want to take the maximum advantage of the plan, then you should know how to file a claim in case of an unfortunate accident. Even if you own the Manipal Cigna Secure Health insurance plan but don’t know the claim process, then it’s of no use. Thus, you will now need to know the claim process of the Manipal Cigna Secure health plan.

Cashless Claim Process:

• The cashless request form, which is available from the network provider and TPA, must be filled out and submitted to the company or TPA for approval.

• The Company/TPA will issue a pre-authorization letter to the hospital after verification once it has received the cashless request form and pertinent medical information from the insured person/network provider.

• The insured person must verify the discharge documents, verify and sign them, and pay for all non-medical and ineligible costs at the time of discharge.

• If the insured person is unable to provide the necessary medical information, the Company/TPA reserves the right to deny pre-authorization.

• If the insured person’s request for cashless access is denied, they may still receive treatment as directed by their doctor and submit their claim paperwork to the company or TPA for reimbursement.

Reimbursement Claim Process:

Use the Reimbursement Claim facility if you want to choose a hospital that might not be accepted by your Manipal Cigna. You can seek medical attention first, pay the bills, and then submit a claim for reimbursement to your insurance company.

For your Manipal Cigna Secure health insurance plan, the following are the crucial steps involved in filing a reimbursement hospitalisation claim:

• Tell Manipal Cigna, your insurance company, about the procedure and the hospital.

• Receive treatment and pay for it out of your pocket.

• Then, submit a claim to your insurance provider.

• Distribute all hospitalization-related paperwork, including doctor’s prescriptions, health invoices, and medical bills.

• The insurance provider will check your documentation. Your claim will be handled in accordance with the terms of your policy and the range of coverage.

Documents to Be Submitted:

The following documents must be attached to the reimbursement claim, which must also be submitted within the allotted time frame.

• Duly Completed claim form.

• Photo Identity proof of the patient

• Medical practitioner’s prescription advising admission.

• Original bills with the itemized break-up

• Payment receipts

• Detailed information about the patient’s medical history is included in the discharge summary. vii. Investigation/Diagnostic test reports, etc., backed by the attending physician’s prescription.

• OT notes or Surgeon’s certificate giving details of the operation performed (for surgical cases).

• Sticker/invoices of the Implants, wherever applicable.

• MLR (Medico-Legal Report copy if carried out and FIR (First information report) if registered, wherever applicable.

• NEFT Details (to enable direct credit of claim amount in a bank account) and cancelled cheque.

• KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML Guidelines

• Legal heir/succession certificate, wherever applicable

• Any other relevant document required by the Company/TPA for assessment of the claim.