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Health Claims

How to register a COVID-19 claim?

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Just like any other regular health insurance claim, you can register the claim by calling on 1800-266-5844 or by sending email to health360@libertyinsurance.in. In case you are not able to get assistance on your COVID-19 claim, pls get in touch with us on 8657421821

Can I avail Cashless facility if tested COVID-19 positive?

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You can opt for the cashless facility if the hospital features in LGI’s Network of cashless hospital. Similar to regular cashless claim, you can visit any Liberty General Network hospital to avail pre-authorization. The claim will settled with the hospital once all the formalities are completed. In case the hospital is not available in LGI network, you may opt for reimbursement claim.

Which documents are necessary for the process of settlement of COVID 19 claims?

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a. Duly filled and signed claim form with policy number
b. Self-attested copy of investigation reports
c. Self-attested copy of discharge summary
d. Self-attested copy of payment receipt
e. Self-attested copy of final bill with detailed breakup
f. Self-attested copy of pharmacy invoices supported by prescriptions, etc.

Where can I get answers to my COVID-19 claim related queries?

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If you have any COVID-19 claim related queries / other queries on your claims, please get in touch at 1800-266-5844 or email us at health360@libertyinsurance.in.

If not satisfied, how can I raise a complaint?

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Above touchpoints should be able to resolve your queries, however if you are not satisfied with the response received, you can write to care@libertyinsurance.in.

Liberty General Insurance offers quick and hassle free claim process through its own dedicated in-house claims processing unit, Liberty Health 360.

Liberty Health 360, by its innovative and holistic approach towards health claims is determined to assist you in the need of the hour.

When To Register Claim?

You should register your claim before at least 48 hours of planned admission. In case of emergency hospitalization, please intimate us within 24 hours of admission.

How do I register a claim?

  • Call us at : 18002665844 (08:00 AM to 08:00 PM all days a week)
  • OR
  • Mail us at : Health360@LibertyInsurance.In
  • OR
  • You may also send a written letter to our in house health claims unit Liberty Health 360 by post or courier.​ ​next to you.

You will get contacted by our claims representative to guide you in further process for claim adjudication.

Here is an indicative list of documents required for all kinds of claims:

  • In-patient Treatment/Daycare Procedures
    • Duly filled and signed Claim Form.
    • Photocopy of ID card / Photocopy of current year policy.
    • Original Detailed Discharge Summary / Day care summary from the hospital. Original consolidated hospital bill with bill no. and break up of each Item, duly signed by the Insured.
    • Original payment Receipt of the hospital bill with receipt number
    • First Consultation letter and subsequent Prescriptions. Original bills, original payment receipts and Reports for investigation supported by the note from the attending Medical Practitioner/ Surgeon demanding such test.
    • Surgeons certificate stating nature of Operation performed and Surgeons Bills and Receipts
    • Attending Doctors/ Consultants/ Specialist's/ Anesthetist Bill and receipt and certificate regarding same
    • Original medicine bills and receipts with corresponding Prescriptions.
    • Original invoice/bills for Implants (viz. Stent /PHS Mesh/ IOL etc.) with original payment receipts.
    • Hospital Registration Number and PAN details from the Hospital
    • Doctors registration Number and Qualification from the doctor
  • Road Traffic Accident
    In addition to the In-patient Treatment documents:
    • Copy of the First Information Report from Police Department / Copy of the Medico-Legal Certificate.
  • In Non-Medico legal cases
    • Treating Doctor’s Certificate giving details of injuries (How, when and where injury sustained)
  • In Accidental Death cases
    • Copy of Post Mortem Report (if conducted) & Death Certificate
  • For Death Cases
    In addition to the In-patient Treatment documents:
    • Original Death Summary from the hospital.
    • Copy of the Death certificate from treating doctor or the hospital authority.
    • Copy of the Legal heir certificate, if the claim is for the death of the principle insured.
  • Pre and Post-hospitalisation expenses
    • Duly filled and signed Claim Form.
    • Photocopy of ID card / Photocopy of current year policy.
    • Original Medicine bills, original payment receipt with prescriptions.
    • Original Investigations bills, original payment receipt with prescriptions and report.
    • Original Consultation bills, original payment receipt with prescription.
    • Copy of the Discharge Summary of the main claim.
  • Ambulance Benefit
    • Duly filled and signed Claim Form.
    • Photocopy of ID card / Photocopy of current year policy.
    • Original Bill with Original Payment Receipt.
    • Treating Doctor’s consultation prescription indicating Emergency Hospitalization.
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  • Reimbursement of Organ Donor Expenses
    In addition to the documents of general hospitalization
    • Organ Function test / blood test proving organ failure.
    • Treatment Certificate issued by the Transplant Surgeon of the hospital concerned.
  • Hospital Cash Allowance- Same as In-patient Hospitalisation treatment
  • Restoration/Reinstatement of the Sum Insured- Same as In-patient Hospitalisation treatment
  • Recovery Benefit- Same as In-patient Hospitalisation treatment
  • Nursing Allowance- In addition to the In-patient Treatment documents:
    • Duly signed prescription for Private Nursing requirement and its necessity from the treating Medical Practitioner
    • Original Bill with Original Payment Receipt of Nursing charges from the utilized Nursing Burrow/Private Nurse
  • We may call for additional documents/ information as relevant to the claim.
    Applicable to all claims under the policy:
    • In the event of the original documents being provided to any other Insurance Company or to a reimbursement provider, the Company shall accept verified photocopies of such documents attested by such other Insurance Company/ reimbursement provider.
  • Claim Document Master
  • Download Health Card
  • Claim Forms

What is meant by cashless hospitalization?

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Cashless Hospitalization facility is available only at Network Hospitals. It enables the insured to obtain admission at designated hospitals subject to obtaining an Authority Letter from Liberty Health 360. In such cases, Liberty Health 360 settles the hospital bills directly on your behalf.

What is the procedure for planned hospitalization (cashless)?

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In the case of a planned admission, you would have first consulted a doctor who in turn would have advised you on the probable date of hospitalization. In such a case, you must apply for an approval of the estimated hospital expenses directly with Liberty Health 360 at least 72 hrs prior to the date of hospitalization. TPA desk or Hospital executive may assist you in filling up the form and the same shall be sent to Liberty Health 360.

Your claim would be assessed in the light of the policy issued to you by your insurance company and a letter of authorization will be issued to the hospital authorizing the patient's treatment. Once the Authority letter is sent to the hospital from Liberty Health 360, you need not pay to the hospital. Liberty Health 360 will pay your hospital bills up to the amount authorized in the Authority letter.

What is an emergency hospitalization (cashless)?

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Emergency hospitalization is a hospitalization which requires immediate admission to the hospital when an insured or covered family member meets with a sudden accident or suffers from a bout of illness.

What is the procedure for emergency hospitalization?

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Step 1: Approach the nearest network hospital.

Step 2: Go to the TPA desk and fill in the Pre-auth form & submit. Hospital would send the filled in pre-authorization request form to Liberty Health 360. Liberty Health 360 will check the liability and send authorization letter (in case if the hospitalization is warranted and admissible under policy terms) or denial letter.

Step 3:

  • If authorization for cashless transaction from Liberty Health 360 has been received
  • At the time of discharge, pay for the services and items that are not covered under the health insurance policy/excess/co-payments/deductibles
  • Verify the bills and sign on all the bills.
  • Leave the original discharge summary and other investigations reports with the network provider. Retain a photocopy copy for your record

In case of non-receipt of authorization from Liberty Health 360 or if authorization is denied by Liberty Health 360

  • At the time of discharge/leaving the network provider premises, please settle the bills in full and collect all the bill documents and reports.
  • Lodge your claim with Liberty Health 360 for processing and reimbursement

Is there any time limit to submit the pre-authorization request?

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In case of emergency or unplanned admission, the hospital must send the pre-authorization request to Liberty Health 360 within 24 hours from the time of admission .In case of planned hospitalization it is prudent to send the pre-authorization request to Liberty Health 360 at least 72 hours prior the admission date. This will ensure a hassle-free admission procedure for you at the hospital.

Are my medical expenses incurred before and after hospitalization covered?

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Yes, Med claim policy allows reimbursement of relevant medical expenses incurred during pre & post hospitalization towards the ailment / disease for which hospitalization was necessitated. This is subjected to the limits prescribed in the policy.

What are the services available to me from the Liberty Health 360?

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• Cash Less service facilitation at network hospitals

• Reimbursement Process or non-network hospitals

• 24hr access to our Call Center through our Toll Free line

• Online assistance during hospitalization and filing of claim document

When I call LGIC Call Center / Office, how will you identify me?

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Please mention your Policy Number or your Health Card Number to the Call Center Executive.The executive may verify other details like your Address, Insurer, Date of Birth, Employer Details etc. On establishing your identity, we will be happy to answer your queries

What documents should we obtain before discharge from the hospital in case of cash less facility availed?

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All bills in original and a discharge certificate are to be left with the hospital providing cashless treatment. The patient has to countersign all bills and fill the claim form and also leave the same with the hospital at the time of discharge. A copy of the bills & Discharge Summary can be carried by the patient for his records and for submission along with Pre & Post Hospitalization bills.

Can I get Cash Less facility / Reimbursement in the case of pre-existing diseases?

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Pre-Existing disease are excluded in Mediclaim Policy (Exclusion No 4.1). Our doctor panel will verify / check the inception of disease based on your medical records and in case the disease has an origin before the inception of the policy, then your claim is not payable, as per the policy.

What is the deadline to submit a reimbursement claim?

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Claim intimation (with particulars relating to policy number, name of the insured person for whom the claim is made, nature of illness/injury and name and address of the attending medical practitioner/hospital/nursing home) should be submitted within 7 (seven) days from the date of hospitalisation/injury.

How long does it take to process the reimbursement claim and when will I receive the payment after approval of the claim?

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After receiving all the required documents, it takes 7 working days to process the claim and 3 banking days after that for payment.

What is the maximum number of claims allowed during the policy period?

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There is no upper limit on the number of claims that can be raised during the policy period. However, the total cumulative claim amount cannot exceed the sum insured in the policy.

What are “Non Admissible Expenses” ?

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Please note the list of non-admissible expenses as per IRDA.

OR

COVID- 19 Assistance


Not happy with our response? In case your queries are still not resolved or not happy with the resolution provided please feel free to call 18002665844 or write to gro@libertyinsurance.in

For agent/intermediary related assistance: We request all our agents to contact their respective sales manager or follow escalation matrix. In case your queries are still not resolved call on 18002665844

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