Ericson Insurance TPA is in the process of building the largest direct billing cashless network hospitals across India.
They have developed their own state-of-the-art IT system and provide a full-range comprehensive health insurance services. This includes enrolment, claims processing, pre-authorization, case management, emergency assistance, network maintenance and other customer services all across the country.
Know Your Customer (KYC) documents include the following:
- Policyholder’s PAN card or any government ID proof
- Patient’s Aadhaar card
- Ericson Insurance TPA card or the policy document
- An insurance or e-card copy
Generate your Ericson Insurance TPA E-card here.
Collect the following documents from the hospital:
- Payment receipts
- Discharge summary
- Package breakup
- Hospital bill breakup
Submit these documents with your claim form. However, ensure that you consider the following things:
- The hospital bills and package breakup have to be on the hospital letterhead or with the hospital deal on it.
- The payment receipts have to match up with the total hospital bill. Include the original bills in your claim.
- In case of pre and/or post-hospitalization expenses claim, submit a copy of the discharge summary. No need to include the hospital bill or the bill breakup.
- Consider the eligible duration for pre and post-hospitalization charges claim.
- All the pre and post-hospitalization expenses such as pharmacy, consultation, lab bills have to be submitted in original backed by the doctor’s prescriptions. Otherwise, Ericson Insurance TPA may reject the claim for those expenses.
Original investigation reports need to be submitted to Ericson Insurance TPA. Reports on plain paper with the lab/hospital stamp may not be accepted.
If you do not have all the reports, you can still go ahead and submit your claim with the documents you have. But ensure that you write a cover note with a date-wise list of reports that are missing in the claim. By doing so, you’ll have time to get hold of the documents and by the time Ericson Insurance TPA raises a query and asks you the submit the remaining reports, you’ll have them ready.
If you could not get the missing documents in time, the amount of those expenses will be deducted from the total claim amount.
If you are claiming for pre and post-hospitalization expenses, ensure that your investigation reports and bills are supported by the doctor’s prescriptions on the official letterhead.
Accident Details, if Applicable
For accident-related claims the following documents are required:
- Medico-legal Certificate (MLC) from the hospital
- FIR copy if the incident was reported to the police.
If the accident is self-injury, write a letter giving details of the accident ruling out the case of self-harm.