IFFCO Tokio Health Insurance Claim Settlement

Cashless claims are of two types:

1. Cashless Claims procedure for Emergency Admission
2. Cashless Claims procedure for Planned Admission
   • Step 1: Select a hospital from our list of network hospitals for treatment
   • Step 2: Intimate our Third-party administrator (TPA) through the Helpline Number before 3 days of admission, quoting your Health card Membership number
   • Step 3: Fill in the cashless request form which is available with the Hospital Insurance Help Desk and get it certified by your treating doctor
   • Step 4: Fax the cashless request form along with supporting medical records to the TPA
   • Step 5: The TPA will scrutinize the document and convey the decision to the hospital. The TPA could sanction the cashless request or call for additional documents if required
   • Step 6: On approval of a cashless claim by TPA, the hospital bills will be settled directly (subject to policy limits). Inadmissible amounts like telephone charges, food, attendant charges etc would have to be settled by you
   • Step 7: If the cashless claim is not approved by TPA, please settle the bill with the hospital and apply for reimbursement. The claim will be processed as per policy terms and conditions

Cashless Claims procedure for Emergency Admission:

1. Step 1: In the case of network hospital, on admission, intimate the Third-party administrator (TPA) through their Toll-free no. Please quote your health card Membership number
2. Step 2: Fill in the cashless request form which is available with the Hospital Insurance Help Desk and get it certified by your treating doctor
3. Step 3: Fax the cashless request form along with supporting medical records to the TPA
4. Step 4: The TPA will scrutinize the document and convey the decision to the hospital. The TPA could sanction the cashless request or call for additional documents if required
5. Step 5: On approval of a cashless claim by TPA, the hospital bills will be settled directly (subject to policy limits). Inadmissible amounts like telephone charges, food, attendant charges, etc would have to be settled by you
6. Step 6: If the cashless claim is not approved by TPA, please settle the bill with the hospital and apply for reimbursement. The claim will be processed as per policy terms and conditions