{"id":592,"title":"DOCUMENT CHECK LIST FOR AUTHORISATION / CLAIM SUBMISSION","purpose":"claim","insurer":{"slug":"indusind-general-insurance","name":"IndusInd General Insurance Company Limited"},"source_pdf":"https://www.indusindinsurance.com/downloads/document-check-list-for-health-claims","sha256":"5fbee53f29ce7b376a4fea82b6aa1fff6a23b7fba5dafb7011801bcf9bd1801e","pages":3,"collected":"2026-10-17","instructions":{"about":"This form lists the documents required for claim submission or pre-authorization requests under health insurance policies. It is used by the insured or claimant to ensure all necessary documents are submitted.","notes":["Refer to the notified hospital list on www.indusindinsurance.com before hospitalization.","Original bills and documents are required unless otherwise stated.","Cancelled cheque must be in CTS 2010 format with printed details; if not, provide passbook or bank statement copy.","Use self-attested copies where required.","PEP means individuals holding prominent public functions as defined under PMLA Rules."],"title":"DOCUMENT CHECK LIST FOR AUTHORISATION / CLAIM SUBMISSION","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Pre-Authorization Request Document Type (At The Time Of Admission)","fields":[{"help":"Submit the completed cashless authorization form signed by insured, doctor, and hospital with seal","type":"attachment","label":"Duly filled Cashless authorization form along with sign/thumb impression of insured, treating doctor & hospital seal","options":[],"required":null,"pdf_field":""},{"help":"Attach the current policy copy or health card","type":"attachment","label":"Current year policy copy/Health Card of the insured","options":[],"required":null,"pdf_field":""},{"help":"Attach proof of age of the insured","type":"attachment","label":"Age Proof","options":[],"required":null,"pdf_field":""},{"help":"Attach the first doctor's prescription mentioning symptom start date","type":"attachment","label":"First prescription of the doctor with commencement date of the symptom of disease","options":[],"required":null,"pdf_field":""},{"help":"Attach accident-related documents if applicable","type":"attachment","label":"In Case of Accident -Copy of Medico Level Certificate from hospital or FIR of local police station or Detailed Police Information note & Drug Influence Certificate (if applicable)","options":[],"required":null,"pdf_field":""},{"help":"Attach investigation reports if available","type":"attachment","label":"Copy of investigation reports supporting diagnosis (If any)","options":[],"required":false,"pdf_field":""},{"help":"Attach discharge summary and final bill at discharge","type":"attachment","label":"Discharge Summary: At the Time of Discharge along with final bill irrespective of approval amount","options":[],"required":null,"pdf_field":""}],"filled_by":""},{"title":"Hospitalization/ Day Care Treatment Document Type (At The Time Of Admission)","fields":[{"help":"Attach authorization form and hospital letter for network reimbursement or claim form for member reimbursement","type":"attachment","label":"For Network Reimbursement- Cashless authorization request form along with authorization letter (must be signed/thumb impression by the patienU claimant prior to discharge from the hospital) & hospital covering letter For Member Reimbursement - Duly filled & signed Claim form","options":[],"required":null,"pdf_field":""},{"help":"Attach treatment documents and doctor's prescription","type":"attachment","label":"Treatment papers along with doctor's prescription","options":[],"required":null,"pdf_field":""},{"help":"Attach original hospital bills and related certificates","type":"attachment","label":"Original Hospital Bills (For Attending Doctors/ Consultants/ Specialists/ Anesthetists- Bill Receipt & certificate regarding diagnosis/ Surgeon's Bill/ Receipt & Certificate - Stating nature of operation performed.)","options":[],"required":null,"pdf_field":""},{"help":"Attach surgeon's bill and certificate describing operation","type":"attachment","label":"Surgeon's Bill/ Receipt & Certificate - Stating nature of operation performed","options":[],"required":null,"pdf_field":""},{"help":"Attach original or attested discharge card with admission and discharge details","type":"attachment","label":"Discharge Card - Original or Attested with Date & Time of admission as well as discharge mentioned in it","options":[],"required":null,"pdf_field":""},{"help":"Attach detailed death summary if applicable","type":"attachment","label":"In Case of Death - Detailed death summary from hospital","options":[],"required":false,"pdf_field":""},{"help":"Attach original stickers and invoices for medical devices used","type":"attachment","label":"Original Stickers & Invoices for the stents, implants, catheters, lens, etc","options":[],"required":false,"pdf_field":""},{"help":"Attach original pharmacy bills with prescription and hospital seal","type":"attachment","label":"Pharmacy Bills (in case medicines purchased from outside, bills in original supported by the prescription of attending Medical Practitioner/ Surgeon with Hospital seal)","options":[],"required":false,"pdf_field":""},{"help":"Attach original lab bills and investigation reports","type":"attachment","label":"Laboratory Bills with Original Investigation reports (X-Ray/ Scan/ ECG/ Laboratory etc)","options":[],"required":false,"pdf_field":""},{"help":"Attach accident-related documents if applicable","type":"attachment","label":"In Case of Accident- Copy of Medico Level Certificate from hospital or FIR of local police station or Detailed Police Information note & Drug Influence Certificate (if applicable)","options":[],"required":false,"pdf_field":""},{"help":"Attach self-attested PAN/Form 60 for claims above 1 lac; photo ID proof for claims below 1 lac","type":"attachment","label":"For claimed amount above 1 lac self attested copy of PAN Card /Form 60 of Insured is mandatory & for below 1 lac claimed amount copy of Photo identity proof (PAN Card/Form 60, Aadhaar Card, Voter ID etc.) is mandatory","options":[],"required":null,"pdf_field":""},{"help":"Attach original cancelled cheque or passbook/bank statement copy with printed details","type":"attachment","label":"Original Cancelled Cheque in CTS 2010 format (Printed account number, IFSC code, Printed name) Mandatory. In case the name is not printed on cheque leaf, scanned copy of 1st page of passbook or the authorized bank statement","options":[],"required":true,"pdf_field":""},{"help":"Attach copy of health card","type":"attachment","label":"Health Card Copy","options":[],"required":null,"pdf_field":""},{"help":"Check hospital eligibility on website before claim","type":"note","label":"Any hospitalization from the notified Hospital will not be entertained. please refer the notified hospital list on our website: www.indusindinsurance.com","options":[],"required":null,"pdf_field":""}],"filled_by":""},{"title":"Critical Illness Claims Document Type (At The Time Of Admission)","fields":[{"help":"Attach specialist doctor's certificate confirming diagnosis and symptom onset","type":"attachment","label":"Original Specialist Doctor's certificate confirming the diagnosis and when the symptoms first occurred","options":[],"required":null,"pdf_field":""}],"filled_by":""},{"title":"PEP Declaration","fields":[{"help":"Select yes or no","type":"choice","label":"Are you a Politically Exposed Person (PEP)?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Write the position if you answered yes","type":"text","label":"If yes, please mention the position held","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"choice","label":"Is any of your close relation or family member a PEP?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Write name, relation and position if yes","type":"text","label":"If yes, please mention the name and relation and the position held by such close relative/family member.","options":[],"required":false,"pdf_field":""},{"help":"Write place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Write date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Pre-Authorization Requests, Hospitalization/Day Care Treatment Claims, Critical Illness Claims, Domiciliary Hospitalization Claims","attachments":["Duly filled Cashless authorization form","Insured's Photo ID Proof","Current year policy copy/Health Card","Age Proof","First prescription of the doctor","Accident related documents (Medico Legal Certificate, FIR, Police Note, Drug Influence Certificate)","Investigation reports","Discharge Summary and final bill","Cashless authorization request form and hospital covering letter (for Network Reimbursement)","Duly filled & signed Claim form (for Member Reimbursement)","Treatment papers and doctor's prescription","Original Hospital Bills and certificates","Surgeon's Bill and certificate","Discharge Card","Detailed death summary (if applicable)","Original Stickers & Invoices for medical devices","Pharmacy Bills with prescription and hospital seal","Laboratory Bills and Investigation reports","Self attested PAN Card/Form 60 or Photo identity proof","Original Cancelled Cheque or passbook/bank statement copy","Health Card Copy","Specialist Doctor's certificate (for Critical Illness Claims)","Doctor's certificate and proof of lack of hospital accommodation (for Domiciliary Hospitalization)"],"declarations":["Declare if you or your close relatives are Politically Exposed Persons (PEP) and provide details if yes.","Confirm to inform the insurer if you or your close relatives become PEP in future.","Confirm all premiums are paid from bonafide sources and not from proceeds of crime.","Understand insurer may verify source of funds and cancel contract if found guilty under money laundering laws.","Consent to insurer verifying KYC and PAN details and accept responsibility for any mismatches."],"dropped_labels":2},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"services@indusindinsurance.com","label":"Health Insurance Claims Email","level":1,"hours":null,"applies_to":"health","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"nce Claim\nTravel Insurance Claim\nCommercial Insurance Claim\nSupport\nSign In\nSelf Help\nVideo Chat\nContact Us\nEmail us at\nservices@indusindinsurance.com\ngrievances@indusindinsurance.com\ncareers@indusindinsurance.com\nCall us at\n+91 22 48903009 (Paid Number)\n+91 22 65934185","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"indusind@europ-assistance.in","label":"Travel Insurance Claims Email","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail:\nindusind@europ-assistance.in\nMobile Application:\nIndusInd Insurance App\nWebsite:\nOnline Claim Intimation\nOffline Visit:\nLocate your nearest branch\nh","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+91 22 48903009","label":"Car Insurance Claim Intimation","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.indusindinsurance.com/car-insurance-claim","quote":"Us\nEmail us at\nservices@indusindinsurance.com\ngrievances@indusindinsurance.com\ncareers@indusindinsurance.com\nCall us at\n+91 22 48903009 (Paid Number)\n+91 22 65934185 (Senior Citizen)\n+91 7400422200 (WhatsApp)\n+91 22 48903051 (Become our Partner)\nVisit us:","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934189","label":"Motor Claims Helpline","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.indusindinsurance.com/car-insurance-claim","quote":"ation.\nNeed Guidance on Car Coverage?\nTalk to Our Professional Advisors\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nSteps to Take After a Car ​Accident\nThe following steps can expedite the road accident insurance","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934188","label":"Health Claims Helpline","level":null,"hours":null,"applies_to":"health","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"your nearest location.\nExpert health advice you can trust\nGet in touch with our team today!\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nCommon Reasons for Health Insurance Claim Rejection\nIncomplete Documentation","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934184","label":"Travel Claims Helpline","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"e you can trust\nGet in touch with our team today!\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nCommon Reasons for Health Insurance Claim Rejection\nIncomplete Documentation\nYour claim gets rejected when you don't gi","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+912248903009","label":"Inland Travel Helpline","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"rds your registered bank account.\nHow to Contact Us For Travel Insurance Claim?\nContact Details\nInland Travel Helpline:\n+912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 552","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"91-22-67347843","label":"International Travel Helpline (abroad)","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"For Travel Insurance Claim?\nContact Details\nInland Travel Helpline:\n+912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 209 5522","label":"International Travel Helpline (in India)","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail:\nindusind@europ-assistance.in\nMobile Application:\nIndusInd Insurance","fetched_at":"2026-10-20"}],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/indusind-general-insurance/592-document-check-list-for-authorisation-claim-submission"}