FHPL was established in 1995 and received its license from IRDA in 2002. The company caters to the needs of policyholders from the private and public sectors.
FHPL has a qualified workforce of hundred doctors and experienced management professionals spread across 40 branch offices. Today, FHPL is a leading company in the insurance sector with 33 million members.
A health insurance claim can be a tricky process. In this article, we have tried to simplify the FHPL reimbursement claim process for you.
KYC simply stands for Know Your Customer. The KYC documents are essential to establish the identity of the policyholder and the patient. You need to submit these KYC documents:
- Aadhaar card copy of the patient
- PAN card copy of the primary policyholder or a valid government ID proof
- FHPL card or the policy certificate
- Original cancelled cheque of primary policyholder’s bank account
To generate your FHPL TPA E-card, click on this link https://www.fhpl.net/FhplLogins/Ecard/Login.aspx?Type=ecard.
Hospitalization & Treatment Documents
Collect the following documents from the hospital:
- Hospital bill
- Payment receipts
- Discharge summary
- Package breakup
- Hospital bill breakup
Consider the following things:
- If the hospital bill is the summary of the expenses, ask the hospital to give the breakup of the bill. If a surgery package reflects in your hospital bill, ask the hospital for the breakup of that too. Ensure that all the bills are on the hospital letterhead or have the hospital’s seal on it.
- The total payment receipt amount has to tally with the total hospital bill. You’ll need to submit these bills in original.
- In case of pre and/or post-hospitalization expenses claim, a discharge summary is enough. The hospital bill or the bill breakup is not needed.
- Consider the eligible duration specified in the policy document for claiming pre and post-hospitalization charges.
- The pre and post-hospitalization expenses such as consultation, pharmacy, and lab bills are to be submitted in original supported by the doctor’s prescriptions. If not, FHPL may reject your claim for those expenses.
The investigation reports in original have to be submitted to FHPL insurance TPA. The report on plain paper with hospital/lab seal on it may get rejected.
If some of the reports are missing, go ahead and submit the claim with whatever documents you have. However, ensure that you write a cover note mentioning a date-wise list of the missing reports. When FHPL processes your claim, they may raise a query asking you to submit the missing report or else they may deduct the amount of those expenses from the total claim amount.
In case of pre and post-hospitalization expenses, your investigation reports and bills need to be supported by the doctor’s prescriptions on the official letterhead.
Accident Details, if Applicable
For accident-related claims, you’ll have to submit:
- A medico-legal certificate (MLC) from the hospital
- FIR copy (if FIR was lodged)
If the accident is a case of self-injury, you must submit a letter signed by the patient explaining the incident in detail.