What documents are required to file a claim? (Super Top-Up)

Here is the list of documents required to file a reimbursement claim in Super Top-Up policy: 

Hospital Documents

1. Discharge Summary 

2. Final Hospital Bill with Breakup

3. All Investigation Bills and Reports

4. Payment Receipts 

5. Pharmacy Bills ( if any )

6. Consultation Bills  ( if any )

KYC documents

7. Proof of Bank Account of the Employee ( Cancelled Cheque, Bank Statement) 

8. ID Proof of the Employee and the Patient ( If the claim amount is more than 1 lac then the PAN card of the employee will be required) 

Proof of Deductible being Exhausted 

9.  Claim documents of the claim that was settled previously by a different insurer ( should be attested by the insurer) 

10.  Settlement letter of the claim that was settled previously by a different insurer. 

1. Duly filled the Part-A Claim form
2. NEFT Bank proof like a cancelled cheque/the first page of the
passbook (With the bank’s seal) /bank account statement
where the primary insured’s (employee’s) Name, IFSC code,
and Account number are pre-printed on the document.
3. Original Discharge summary with hospital seal and signature.
4. Original Final hospital bill with the hospital seal and
signature.
5. Payment receipt for the main hospital bill with payment
mode mentioned with hospital seal and signature.
6. Detailed breakdown of the final hospital main/ lab/pharmacy
bill (Original)
7. All Medicine bills with relevant prescriptions
8. All investigation Bills
9. Govt ID (Aadhar/ Driving License/PAN Card/ Voter ID) - For
both employee and the beneficiary
If the claim amount is more than 1 lac then the PAN card of the
employee
10. All the investigation/scan reports from the hospital as per
the bills shared.
11. Kindly self-attest all the claim documents by mentioning
"Submitted to Care Insurance" in blue ink pen along with your
signature (Should be handwritten only).

 

12. GMC policy copy of another insurer
13. Insurer attested documents of the last claim settled
with another insurer
14. Settlement letter of the last claim settled with
another insurer