Claims form FAQs

1) What does Company/TPA ID stand for?

Company/TPA (Third Party Administrator) ID represents the health ID number.  This can be viewed on the Plum dashboard under the ‘Health Insurance' section.

2) What is SI/Certificate No? 

SI (Social Insurance) / Certificate number is not a mandatory field on the form. Therefore, it can be left blank.

3) Who is the 'Primary Insured' in my policy? Is it me or the person hospitalized? 

'Primary insured' is the employee under whose name the insurance cover is active.

4) Where do I list the breakup of expenses which are not mentioned in the 'Details of Hospitalization' section? For e.g. pharmacy expenses.

These expenses can be mentioned under “Details of bills Enclosed”

5) I have multiple bills to claim, but the 'Details of Bills Enclosed' has space for only 10 rows. How do I go about listing all the bills?

If there are multiple bills related to the same category, these can all be mentioned under a single bill

For e.g., multiple investigation bills can be clubbed into a single bill and the cumulative amount of all investigation bills can be mentioned. 

6) I have already come back from the hospital, and now I am being asked to fill part B of the claim form. Is this mandatory to fill out?

Yes, this is a mandatory requirement by the insurer, and it must be filled out. 

Exception in the case of ICICI Lombard:

Part B is required in the case of main hospitalization expenses and will be filled by the hospital. With OPD expenses, pre and post-hospitalisation expenses, part B of the claim form is not required.