The Complete Guide to Vipul
MedCorp TPA Health Insurance Claim Process

Vipul MedCorp Insurance TPA Private Limited is promoted by the Vipul Group for TPA activities. The company has obtained a license from IRDA and specialises in managed healthcare facilitation. It offers a wide variety of products and services in the following 4 areas:

  • Third party administration services
  • Preferred Service Provider (PSP) Networks
  • Claim processing and back office operations
  • Healthcare support services

Vipul MedCorp Cashless Claim Process

  • Approach the network hospital with your insurance e-card and an original ID proof for pre-authorization. The insurance TPA will issue the pre-authorization depending on the terms and conditions of the policy.
  • Cashless treatment will be approved according to the services covered in the policy.
  • The policyholder must sign the Vipul Mediclaim form and submit original bills and receipts at the network hospital.

To view the Vipul MedCorp cashless hospital list, please click here

Vipul MedCorp Reimbursement Claim Process

If you choose not to get treated at the Vipul MedCorp network hospital, you can opt for reimbursement benefits. Here’s the reimbursement claim process:

  • If you are going to get hospitalized, fill the intimation form at least 3 to 4 days in advance. In case of emergency, inform the TPA within 24 hours of hospitalization.
  • Get the Vipul Mediclaim reimbursement claim form and fill the details.
  • Attach all the original documents as specified by the TPA with the claim form.
  • Send the form and the documents to the TPA in a week’s time after the discharge.
  • Keep track of the Vipul MedCorp claim status so that you can resolve queries without any detail.
  • Once your documents are verified, you will receive the claim amount within 15 days in your bank account.

Documents Required for Vipul MediCorp

KYC Documents

KYC documents help Vipul MedCorp TPA establish your identity. You will need to submit:

  • The patient’s Aadhar card copy
  • A valid government ID proof, PAN card preferred, of the insured
  • Vipul MedCorp e-card copy
  • An original cancelled cheque that belongs to the policyholder’s bank account

Hospitalization Documents

You will need to attach all the original hospitalization documents with the form. And by original, we mean the documents printed on the official letterhead of the hospital. Documents you will need to submit:

  • Discharge certificate
  • Doctor’s consultation document
  • Cash memos, bills, and receipts
  • Surgeon’s bill and receipt, if applicable
  • Attending doctor’s bill and certificates
  • Anaesthetist’s bill and specialist’s bill

Investigation Reports

  • Lab investigation reports ECG
  • Doctor’s request for an investigation

Note: While the bill breakups can be accepted on a plain paper with hospital’s seal, the investigation reports must be on the letterhead of the hospital.

Accident Details, if Applicable

  • If you’re opting for a treatment due to an accident, submit the Medico-Legal Certificate to the TPA.
  • If the accident has been reported, give the TPA a copy of FIR as well.
  • If you’ve undergone a treatment due to self-harm or self-injury, write a letter with the details and sign it before submitting it to the TPA.

Vipul MedCorp TPA Claim Form

Attach the documents mentioned above with the Vipul MedCorp TPA claim form

Download the Vipul MediCorp form

How to Fill Vipul MedCorp Claim Form

Section A

Section A takes the personal information of the insured, for example, the name, age, address, contact details, etc.

Section B

Fill the information of the additional policy, if the patient holds any, in this section. Ignore the section if the patient doesn’t have additional cover.

Section C

Section C is for the patient. Fill the patient’s information including age, gender, occupation, and their relation with the insured.

Section D

Section D is for the hospitalization details. It would contain information including, the hospital name, the room category chosen, the nature or type of the treatment, date of hospitalization, date of discharge, and FIR & Medico-Legal Certificate.

Section E

Fill the summary total of the bills in section E. The total charges would include the pharmacy expenses, blood-bank charges, diagnosis charges, etc. Fill the pre and post hospitalization costs against their specified fields. Use the separate fields in the section to fill the costs incurred against ambulance, health-checkups, blood bank, etc.

Section F

List all the expenses in order in the 10 spaces for bills in this section. If the number of bills exceeds 10, you can use a separate page and attach it with the form. Mention the total pre-hospitalization, hospitalization and post-hospitalization charges in this order in the first, second and third rows. Mention the pharmacy charges in the 4th row.

Section G

Enter the accurate bank details of the policyholder in this section. This is the account the insurance company will credit the claim amount in. Mention your PAN card number if the bill amount exceeds 1 Lakh.

Section H

The claimant declaration needs to be signed in section H.

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Submission Timeline

Usually, the policyholder gets a 15 to 30-day claim submission time. But if you don’t have certain documents, you can add a cover note on top of your claim application with the list of the documents missing. Doing this you will be able to send the documents within 30 days of discharge so that your claim isn’t rejected. You can always get hold of the remaining documents later and send them to the TPA when a query is raised.

To check the Vipul MediCorp claim status, enter your policy number on the website or call Vipul MediCorp customer care.

Claim Submission Address

Click this link to view addresses of all the Vipul MedCorp TPA centres.

Corporate policyholders must submit their claim forms as well as the documents to a Vipul MedCorp representative when they visit your offices premises.

Ambiguity in details filled in the form or absence of documents can lead to claim amount deductions, and even claim rejection.

Frequently Asked Questions

Follow this link and fill the form to inform Vipul Medcorp TPA about the claim.

Note: Vipul Medcorp TPA should be itimated 3 to 4 days in advance. The delay in claim intimation is acceptable if the hospitalisation wasn’t planned. Even in that case, the TPA must be intimated within 24 hours of the admission.

Vipul Medcorp TPA usually takes 3 to 4 weeks to verify and approve a claim. However, this is possible only when you submit the original medical documents requested by the TPA on time. If you fail to do that, claim approval takes longer than a month. Once the claim is approved, your insurance company will take another 2 to 4 weeks to process the claim amount.

The original bills and discharge certificate must be left with the hospital. While getting discharged, you must countersign the original documents, and take copies of all these documents with you for the record.

To check your Vipul TPA claim status, type a message ‘VMCCLAIM’ and send it to 56677.

Example: VMC CLAIM 54321

No, you need not fill part B of the claim form. Vipul medcorp claim form is the equivalent of IRDA claim form part A.

You can submit Vipul claim form within 7 days of the discharge date. Documents can be submitted within 15 days of discharge.

When you buy a policy, you will receive your ID card and a guide book which consists of the list of network hospitals. You can also download the list on Vipul MedCorp TPA’s website under the section ‘Hospital Info’. Here’s the link:

Yes. You can claim any number of times. However, if the insured amount is exhausted, you will not be able to claim.

Your policy would cover 30 days pre-hospitalisation expenses and 60 days post-hospitalisation expenses. Pre-hospitalisation claims can be filed along with the hospitalisation expenses. And, the post-hospitalisation costs can be claimed within 60 days after the discharge.

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