We at BizWorld recommend HealthFirst-Cover more for you and your family to cover all the unexpected medical expenses and tragedy that might occur unplanned or planned. With HealthFirst-Cover More at your cover. You and your family will not be affected with the expenses and its effects. It s our responsibility to keep you safe, healthy and tension free in those medical days. To Download our Insurance Network List Click Here National Insurance is the pioneer of this product with 106 years of its rich expertise in India under various Insurance products. HealthFirst has been a unique product under its belt and the best in its class and features. One of the cheapest Mediclaim policy in the current market. Covers your complete family under one roof. Cashless facility. Best claim ratio. 3200+ hospitals under the list. 24*7 Assist by our TPA channel. HealthFirst-Cover More features: Age Limit 3 Months to 80 Years Sum Insured Rs. 1,00,000 to Rs. 5,00,000 (in multiples of Rs. 1,00,000) No Medical Tests. Self-Declaration is required for all persons above age 45 yrs Family means Self, Spouse, 2 Children (upto 25 yrs) and 2 Dependent Parents upto 80 yrs. Dependent parents also can claim 100% of the Sum Insured. 24 Hrs. hospitalisation is necessary. Medical Expenses towards specific technologically advanced day care treatments / surgeries where 24 hrs. of hospitalisation is not required. Medical expenses related to your treatment of 30 days before and 60 days after hospitalisation are payable. Maternity benefits are covered after 1 to 2 year waiting period. Ranging Rs. 15,000 to 25,000 based on sum assured. Pre-Existing diseases are covered after 2 claim free years. (* conditions apply) Ambulance charges upto Rs. 1,000/- Hospital Room Rent 1% of the Sum Insured per day for regular room and 2% of the Sum Insured per day for ICU / ICCU expenses.
For Proposer / Dependents above the age of 60 years 20% to 50% Co-Payment is applicable on all claims. But 100% payable in Accidental Case. Surgeons, Medical Practitioner, Consultants and Specialists Fees will be upto 25% of Sum Insured per Illness. Proposer / Dependent can get Cataract Benefits Rs. 15,000 to Rs. 30,000 per eye. Claims are settled by our TPA {Dedicated Healthcare Services (India) Pvt. Ltd.} If the services of TPA are not satisfactory then the company has the right to change the TPA. o o Cash less hospitals across India. Reimbursement facility in all non-cashless hospitals available. Policy has to be renewed before the expiry date. However a grace period of 7 days will be provided for consideration of renewal but any claim during the break period will not be paid. As per clause 4.3, certain diseases like Cataract, Benign Prostatic Hypertrophy, Hysterectomy arising out of Menorrhagia, Hernia, Fibromyoma, Sinusitis and related disorders. Please refer to the terms & conditions for all other underwriting guidelines. o Tax benefits under Sec 80D applicable, upto 15,000/-. Attachments on this page: List of Cashless Hospitals attached-latest update. Copy of Policy document. Copy of Cashless card. Documents required for taking this policy: One Age proof of each member-pan card/birth certificate/pass Port/Election Card/ Driving Lic. One Photograph of each member. Address proof. Signature of Proposer. Premium cheque.
Did you know? As per the Insurance law, a single customer can own a Health/Mediclaim insurance from one or more insurance providers. And in situation of claim, the claimant can take sharing benefits from both or single company as per the claim amount. Eg: If Mr. X has Two Mediclaim policy from 2 different providers. 1 st provider has a cover of 3Lac and 2 nd provider has 5Lac. Situation 1: If the policy holder gets an medical expense of 3Lac then, he/she can claim it from either of the provider. Situation 2: If the policy holder gets a medical expense of 6Lac then, he/she can claim it from both of the providers in sharing mode for a worth of 6Lac. Both the provider will share the claim respectively. Health Is Wealth, and health is the most important aspect of each human life. Preserve it, care it and prosper it with our support and care. Stay Healthy. TPA Details: Dedicated Healthcare Services TPA (India) Private limited Toll Free no. 1800-209-0201 Call center No. -022-67354300 To serve you better For any emergences or queries kindly call us on our 24*7 Toll free or call center. Let us know if you have changed your telephone number or address. To download your E-card or to check your claim status, kindly log on to our website www.dhs-india.com. To avail of electronic fund transfer facility for your claim settlements, kindly let us know your bank details and your account number. To avail of our SMS alerts for all your claim status, kindly let us have your mobile no. Please make use of our toll free fax no. 1800-209-0201 for the purpose of sending your pre authorization forms from anywhere in India. Guidelines: Identity card- On the basis of details provided by your Insurance company. DHS will issue an identity card to each beneficiaries under the policy. The identity card contains an identity number, which is unique to each insured under the policy. Please quote the DHS ID number in case of any correspondence for faster response. The ID card is to be properly maintained by the insured in order to avail cashless facilities from our network hospitals. This ID card is issued only for identity purpose and should not be considered as an authorization to the hospitals to proceed with the treatment.
Claim process: Guidelines for availing cashless hospitalization: Cashless facility can be available at any of the network hospitals by the insured. Please check the list of hospitals in our network forming a part of your welcome kit. It is also advised to check our website www.dhsindia.com for updated list or call our Toll free no. or call center. Cashless Facility Procedure: Claims in respect of Cashless Access Services will be through the list of network of Hospitals / Nursing Homes and is subject to pre admission authorization. The TPA shall, upon getting the related medical information from the Insured persons/ network provider, verify that the person is eligible to claim under the policy and after satisfying itself will issue a pre-authorization letter / guarantee of payment letter to the Hospital/ Nursing Home mentioning the sum guaranteed as payable, also the ailment for which the person is seeking to be admitted as a patient. The TPA reserves the right to deny pre-authorization in case the insured person unable to provide the relevant medical details as required by TPA. The TPA will make it clear to the Insured person that denial of Cashless Access is in no way construed to be denial of treatment. The Insured person may obtain the treatment as per his/her treating doctor's advice and later on submit the full claim papers to the TPA for reimbursement subject to admissibility of the claim as per terms and conditions of the Policy. Pre authorization for Cashless Services in Network hospital / Nursing Home is within the authority of TPA and will be given after verification of required documents pertaining to treatment of the Insured to the satisfaction of TPA.
List of Documents required for Cashless Procedure List Of Documents Pre-Authorization Form Current Year s Policy Copy TPA ID Card Photo ID Proof Previous / First Consultation Papers Positive Investigation Reports Details Pre-Authorization form should be filled & Signed by Patient / Treating Doctor / Hospital Authority Insurance Policy Certificate Copy of TPA ID Card Pan Card / Voting ID Prior to Hospital Doctor consultation papers or reports related to Illness Positive finding on Investigation reports Note: All above documents should be faxed to TPA in advance in case of Planed Hospitalisation to avail the cashless facility timely. In case of sudden hospitalization, the Insured is required to intimate to TPA/ Insurance Company or Karvat within 48 hrs of Hospitalization or at least before discharge from the Hospital. Select the hospitals/nursing home from our network list. Show the ID card which is sent along with your welcome kit and obtain the cashless request form from the hospital. Hospitals/nursing home submits the duly filled cashless request form to DHS. Get admitted, take treatment and get discharged without payment of bill. Please ensure that claim form is filled and duly signed and final bill is signed prior to discharge. Hospitals/Nursing home will submit all claim documents along with bills to DHS. Payments will be made to hospitals/nursing home directly by DHS.
In case of emergency hospitalization, the patient first gets admitted into our network hospital and then proceeds with all the aforesaid steps. Steps to be followed in case of filling a reimbursement claim: Every insured, who is desirous of filling a claim for his hospitalization has to give a prior intimation to DHS in case of planned hospitalization or within 24 hrs of hospitalization in case of emergencies. Claim intimation can be sent either through fax, courier or e-mail to our nearest DHS branch. Insured is hospitalized in non Network hospital/ Nursing home. Intimation of the claim to be sent to DHS local office. Insured undergoes treatment and gets discharged from hospital/nursing home. The bill is settled directly by the insured. Insured submits a duly filled claim form and supporting documents to DHS within 7 days from date of discharge. Post hospitalization bills should be submitted after 7 days from completion of treatment or after 60 days of discharge whichever is earlier. DHS process the claim and if the documents are in order, reimburses the amount claimed to the insured. Documents to be attached while submitting reimbursement claim: Final Claim documents as per below list must be submitted to the TPA within 30 days from the Date of Discharge from the Hospital. In case the Post Hospitalisation, Treatment (limited to 60 days), all claim documents should be submitted within 7 days after completion of such treatment. List of Mandatory Documents required for Reimbursement Claim and to be submitted in Original. List of Documents Details Claim Form Claims form duly filled & signed by Insured or Claimant Insurance Certificate Copy All current & previous year insurance certificate copy TPA ID card Copy of TPA ID Card Claim Intimation Copy Copy of Claim Intimation to Karvat / Insurance Co / TPA Previous Claim Details Details of any previous claim settlement Admission / Discharge Card Detail of Hospitalisation Hospital Bill / Receipt Detail of payment given to hospital Investigation Report X ray Report, ECG report, Pathological report any other Bill / Receipt of Pathology Lab Payment detail of Investigation reports Medicine Bills Bill with prescription of doctor Surgeon / Consultation Bills Detail of surgeon fees
Pre & Post Hospitalizations Bills ICP Registration Certificate Previous / First Consultation Papers All medicine / Investigation Bills & Reports Attested Copy of Indoor Case Papers from hospital Current Year s copy of registration certificate Of the Hospital from Local Authority Prior hospital Doctor consultation or report related to illness Note : Waiver of this condition may be considered in extreme cases of hardship where it is proved to the satisfaction of the Company that under the circumstances in which the insured was placed it was not possible for him or any other person to give such notice or file claim within the prescribe time limit.