Health & Cancer Protection Plus Claims

Public Notice

To all the customers of Reliance Nippon Life Insurance Company Limited who have availed our health insurance facility:

In compliance with the Master Circular on Health Insurance Business, please be informed that claims related to the cashless facility will be processed only during the working hours from Monday to Friday. We assure you that all claims will be handled in accordance with the regulatory guidelines.

Thank you for your understanding and cooperation.

Documents required

• Cashless Request Form – duly filled in by the Insured (available at TPA desk in Network Hospitals)
• Copy of Health Card
• KYC document of the Insured / Patient
• Original Discharge Summary and other Investigation Reports will be retained by the Hospital

Documents required

• Standard Reimbursement Claim Form Part A – to be filled by the Insured
• Standard Reimbursement Claim Form Part B – to be filled by the Insured and Hospital
• Discharge Summary from Hospital
• All Investigation Reports, Doctors' prescriptions
• Hospital bill, Hospital payment receipts, Pharmacy bills with date
• A Break-up of Investigation charges (under main hospital bill)
• MLC/FIR/ Self declaration for accidental injury/treatment
• KYC document of the Insured / Patient
• Bank details of the Insured - Personalized cancelled Cheque or Completed Bank Authorization Form, attested by the Bank, along with a self-attested copy of Passbook / Bank Statement with IFSC and Bank Account number mentioned thereon

NOTES

All documents to be submitted in original.

Reimbursement Claims can be lodged by visiting nearest RNLIC branch office.

The Insurer / TPA may call for additional documents, on a case to case basis, to evaluate the merit of a claim

Documents required

• Claim Form – Hospital Cash Benefit - to be filled by the Insured
• Copy of all Hospital records (Admission Notes, Discharge Summary and Test / Investigation Reports)
• Attending Doctor's/Surgeon's certificate supporting hospitalization (including ICU admission if any), diagnosis and treatment
• Hospital Bill and receipts for payment
• Copy of FIR (in case of accident)
• KYC document of the Insured / Patient
• Bank details of the Insured - Personalized cancelled Cheque or Completed Bank Authorization Form, attested by the Bank, along with a self-attested copy of Passbook / Bank Statement with IFSC and Bank Account number mentioned thereon

Additional documents in case of claim under Critical Conditions (25) Rider / Major Surgical Benefit in Wealth + Health Plans

• Claim Form – Critical Illness (25) Rider - to be filled by the Insured
• Claim Form – Major Surgical Benefit - to be filled by the Insured
• Specialist Doctor’s certificate confirming the diagnosis and when the symptom first occurred / stating nature of operation performed

NOTES

Photocopies of all documents should be attested by a Reliance Nippon Life Insurance Official.

The Insurer / TPA may call for additional documents, on a case to case basis, to evaluate the merit of a claim.

Documents required

• Claim Form – to be filled by the Insured
• Certificate from Attending Medical Practitioner confirming the date of diagnosis
• Original and Copy of Policy Document
• All Medical Records including the following:
• Original Discharge / Death Summary Card
• Indoor case papers
• Copies of Hospital Bills, Pharmacy/Investigations Bills
• Investigation Reports
• Details of the treatment received by the Insured from the inception of the ailment
• Letter from Treating Consultant stating presenting complaints with duration and past medical history
• Histopathology / Cytology / FNAC / Biopsy / Immuno-histochemistry reports
• X-Ray / CT scan / MRI scan / USG /Radioisotope / Bone scan Reports
• Blood Tests
• Any other specific investigation done to support diagnosis such as PAP Smear / Mammography, etc.
• Death Certificate issued by local Municipal Corporation or Competent Authority (where applicable)
• KYC document of the Insured
• Bank details of the Insured - Personalized cancelled Cheque or Completed Bank Authorization Form, attested by the Bank, along with a self-attested copy of Passbook / Bank Statement with IFSC and Bank Account number mentioned thereon

NOTES

In the event of death of the Life Insured prior to claim intimation, the relevant forms/documents are to be filled/provided by Nominee/ Claimant under the policy

Photocopies of documents should be attested by a Reliance Nippon Life Insurance Official.

The Insurance Company reserves the right to ask for additional documents/information