The objective of this article is to educate the claimant regarding the reimbursement claim process followed by Vipul MedCorp TPA. The essential steps involved are a collection of claim documents, preparation of claim form and submission of claim documents to Vipul MedCorp. So let’s get started with Vipul MedCorp reimbursement claim process.
Collection of Vipul Mediclaim Documents
Before you get down to claim preparation, you must collect all the relevant claim documents. For a hospitalization claim, you will require:
- Discharge Summary
- Hospital Main bill
- Bill breakup
- Package breakup
- Payment receipts
- Implant stickers, if applicable
- Lab and scan reports
- Pharmacy bills
Bear in mind that all these documents need to be in original and on the colored/printed letterhead of the hospital. Bill breakup is the split of various categories of items included in the bill. If any surgery package has been billed to you, a separate breakup of this package is required.
Other points to keep in mind:
- The total of payment receipts should match the amount in the hospital main bill. Make sure you are attaching all the advance and final settlement receipts in the claim.
- Reconcile the number of lab and scan reports with the number of such investigations as per bill. Basically, you must submit reports for every investigation billed to you.
- Lab reports must be on colored/printed letterhead of hospital/center. Some hospitals provide black and white prints of reports or prints on plain paper with their seal on the pages. Insurers generally do not accept these are proof and only the colored/printed reports on letterhead satisfy their requirement.
Download Vipul MedCorp Claim Form
You will need 2 forms in case of hospitalization claim. Vipul MedCorp uses IRDA Claim forms for processing claims. The IRDA Claim Form Part A needs to be filled by the patient and IRDA Claim Form Part B has to be filled by the hospital at which the treatment was taken.
How to Fill Vipul MedCorp Claim Form
Vipul MedCorp claim form has eight different sections, starting from section A till H.
Patient’s details need to be filled in section C, including their name, age, gender, occupation etc. Details of the policy in which the claim is being applied have to be mentioned in section A. You can mention policy number or Vipul Member ID of a primary policyholder or both. The primary policyholder is the one who is proposer in the policy or the employee in corporate policy. Please be informed that the contact details you mentioned in section A will be used by Vipul MedCorp to update you regarding claim status.
If the patient is covered in any other policy, mention those details in section B.
Here the hospitalization details need to be entered, including hospital name, room category occupied by a patient, date of admission and discharge and the reason for hospitalization. If the patient met with an accident or injured himself/herself, use ‘injury’ as the reason. ‘Maternity’ is for delivery cases. Everything else would fall under ‘Illness’.
List down all the bills in section F. Total the bill amounts during the period admission till discharge and fill it as Hospitalization expenses in section E. Total of all bills before admission is to be filled against Pre-hospitalization expenses. Same way, a total of all expenses after discharge have to be filled in Post hospitalization expenses.
The bank account in which you want the reimbursement amount to be credited has to be mentioned in Section G. Bank account should be of the primary policyholder. In the ‘Cheque / DD payable details’ field, mention the name of primary policyholder as per bank account details. For claim amounts, more than one lakh, mention the PAN number of a primary policyholder in the requisite field.
A claimant must put their signature in section H.
Claim Submission Timeline
The claim must be submitted within 15 days after discharge, otherwise, Vipul MedCorp can decline your claim. If you are delayed in claim submission due to any reason, attach a letter with your claim justifying the reason for a delay.
If the delay in claim submission is unavoidable, then one this you can do to meet the deadline is that you submit a claim form and whatever documents available with you to Vipul MedCorp within the timelines. Afterward, Vipul MedCorp will raise the query in the claim asking for remaining documents. This gets you some extra days to gather claim-related documents. The insurer may raise more queries regarding your claim. Don’t lose sleep when your insurer hands over a long list of queries. Our experts simplify these for you and help you respond confidently for a successful claim
You can submit the claim in your company (in case of corporate policies) or you can send the claim to the following address:
Vipul MedCorp Insurance TPA,
#110, 4th Floor, K.H. Road, Next to Suzuki Showroom, Sudhama Nagar, Raja Ram Mohanroy Extension, Sudhama Nagar, Bengaluru, Karnataka 560027
Please make sure that you keep the courier or postal receipt safe with yourself till claim approval. You may require it to help Vipul MedCorp to track your claim.