Founded in 1996, Genins India Insurance TPA’s main objective was to increase health insurance along with effective health care management.
It is one of the pioneers in the field since 2002 when they started TPA operations much before the norms were promulgated by the IRDA. Genins India TPA also provides pre-insurance health check-up and implementation of end-to-end RSBY project on behalf of various insurance companies.
Know Your Customer (KYC) is essential to verify policyholder’s identity. These documents may include:
- Patient’s Aadhaar card copy
- Policyholder’s PAN cardcopy (in absence of PAN card, any government-issued ID proof can work instead)
- Genins India or the insurance policy certificate
- Acancelled chequewith plan holder’s banking account details
Generate your Genins India TPA E-card here.
Hospitalization and Treatment Documents
Documents such as payment receipts,discharge summary, package breakup, hospital bill, hospital bill breakup, etc. given by the hospital have to be submitted along with the claim form. Only original documents printed on the hospital’s letterhead are accepted for claims. Consider these checkpoints while collecting the documents from the hospital:
You’ll be given a hospital bill which is a summary of all expenses. Ensure that you have the breakup of the bill.
- If a surgery package has been added to your hospital bill, ask for the package breakup printed on the hospital’s letterhead. The breakup printed on plain paper with the hospital’s seal may work too.
- Collect the receipts of all the payments you made to the hospital. Tally the receipt amounts with the final bill amount. Include them all in your claim.
- For pre and post-hospitalization, the break of the bills or the bill itself is not needed. You just need to submit a photocopy of the discharge summary.
- Remember to check the eligibility for the duration in case of pre and post-hospitalization. Also, include pharmacy, consultation, lab and consultation bills (all in original) in your claim.
- Provide the doctor prescriptions (original) to support all your pre and post-hospitalization bills you are including in your claim. Otherwise, Genins India may not pay you for those expenses.
Reconcile your reports with the lab investigation reports and scans billed by the hospital. have all these reports have to be in original printed on the hospital’s and/or the lab’s letterhead. Genins India may not accept a print on a plain paper with hospital/lab seal.
Avoid missing out on any reports in your claim. Otherwise, Genins India may deduct the expenses incurred for those investigations during the processing of the claim. Or it may raise a query and ask you to submit the missing reports.
The best thing you could do if you don’t have some reports is to write a cover note enclosed with your claim. In the cover note, you may just list the reports you are not going to submit because you don’t have them.
For pre and post-hospitalization claims, all investigation/lab bills need to be supported with the investigation reports. And each of these reports needs to be supported by the doctor’s prescription that’s written/printed on their letterhead or on a lab requisition slip.
Accident Details, if Applicable
For accident-related claims, medico-legal Certificate (MLC) from the hospital and an FIR copy are needed.
In case of self-injury, a signed letter explaining the details of the injury needs to go along with the claim.