East West Assist TPA PVT Ltd was licensed by the Insurance Regulatory & Development Authority (IRDA) on May 16, 2002 to work as a dedicated insurance Third Party Administrator (TPA). It has a vast experience and a team of experts with the right skills who offer smooth and reliable TPA services in the healthcare insurance industry.
Before reviewing your case, the insurance company establishes your identity using the KYC documents. So, you will need to submit:
- Patient’s Aadhaar card copy
- The insured person’s PAN card copy
- East West TPA card or policy certificate
- Policyholder’s cancelled original cheque
You can get your East West TPA e-card by clicking here.
Submit all the original hospitalization documents, i.e. documents on the letterhead of the hospital. Documents include:
- Bill summary
- Bill break up
- Discharge summary
- Payment receipts
- Additional package breakup
- Doctor’s prescription
- Pharmacy bills
- Operation theatre notes, etc.
For pre and post hospitalization claims, you don’t need to submit the bill breakups; you can just submit the discharge summary. In this case, ensure that you submit the lab bills, pharmacy bills, and consultation bill with your East West TPA reimbursement claim form.
Reconcile the investigation bills with your reports. Make sure that the reports are original, i.e. on the hospital’s letterhead. East West TPA will not accept reports printed on a plain paper with the seal.
If you’re unable to submit the investigation reports right away with the reimbursement claim form, then add a cover note and list of reports in the correct date-wise order with the form.
For pre and post hospitalization, the investigation reports must be attached with the doctor’s original prescription printed on the letterhead or the lab requisition slip.
Accident Details, if Applicable
- Medico Legal Certificate
- FIR, if you have reported the incident
If it’s the case of self-harm or an injury caused due to self, then enclose a letter with the details of the incident and the patient’s signature.