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Health & Cancer Protection Plus Claims

Cashless Claims

Documents required
  • Cashless Request Form – duly filled in by the Insured (available at TPA desk in Network Hospitals)
  • Copy of Health Card
  • KYC document of the Insured / Patient
  • Original Discharge Summary and other Investigation Reports will be retained by the Hospital

Reimbursement Claims

Documents required
    • Standard Reimbursement Claim Form Part A – to be filled by the Insured
    • Standard Reimbursement Claim Form Part B – to be filled by the Insured and Hospital
    • Discharge Summary from Hospital
    • All Investigation Reports, Doctors' prescriptions
    • Hospital bill, Hospital payment receipts, Pharmacy bills with date
    • A Break-up of Investigation charges (under main hospital bill)
    • MLC/FIR/ Self declaration for accidental injury/treatment
    • KYC document of the Insured / Patient
    • Bank details of the Insured - Personalized cancelled Cheque or Completed Bank Authorization Form, attested by the Bank, along with a self-attested copy of Passbook / Bank Statement with IFSC and Bank Account number mentioned thereon
NOTES

All documents to be submitted in original.

Reimbursement Claims can be lodged by visiting nearest RNLIC branch office.

The Insurer / TPA may call for additional documents, on a case to case basis, to evaluate the merit of a claim

 

Wealth + Health Claims

Documents required
    • Claim Form – Hospital Cash Benefit - to be filled by the Insured
    • Copy of all Hospital records (Admission Notes, Discharge Summary and Test / Investigation Reports)
    • Attending Doctor's/Surgeon's certificate supporting hospitalization (including ICU admission if any), diagnosis and treatment
    • Hospital Bill and receipts for payment
    • Copy of FIR (in case of accident)
    • KYC document of the Insured / Patient
    • Bank details of the Insured - Personalized cancelled Cheque or Completed Bank Authorization Form, attested by the Bank, along with a self-attested copy of Passbook / Bank Statement with IFSC and Bank Account number mentioned thereon

Additional documents in case of claim under Critical Conditions (25) Rider / Major Surgical Benefit in Wealth + Health Plans

    • Claim Form – Critical Illness (25) Rider - to be filled by the Insured
    • Claim Form – Major Surgical Benefit - to be filled by the Insured
    • Specialist Doctor’s certificate confirming the diagnosis and when the symptom first occurred / stating nature of operation performed
NOTES

Photocopies of all documents should be attested by a Reliance Nippon Life Insurance Official.

The Insurer / TPA may call for additional documents, on a case to case basis, to evaluate the merit of a claim.

Cancer Protection Plus

Documents required
  • Claim Form – to be filled by the Insured
  • Certificate from Attending Medical Practitioner confirming the date of diagnosis
  • Original and Copy of Policy Document
  • All Medical Records including the following:
  • Original Discharge / Death Summary Card
  • Indoor case papers
  • Copies of Hospital Bills, Pharmacy/Investigations Bills
  • Investigation Reports
  • Details of the treatment received by the Insured from the inception of the ailment
  • Letter from Treating Consultant stating presenting complaints with duration and past medical history
  • Histopathology / Cytology / FNAC / Biopsy / Immuno-histochemistry reports
  • X-Ray / CT scan / MRI scan / USG /Radioisotope / Bone scan Reports
  • Blood Tests
  • Any other specific investigation done to support diagnosis such as PAP Smear / Mammography, etc.
  • Death Certificate issued by local Municipal Corporation or Competent Authority (where applicable)
  • KYC document of the Insured
  • Bank details of the Insured - Personalized cancelled Cheque or Completed Bank Authorization Form, attested by the Bank, along with a self-attested copy of Passbook / Bank Statement with IFSC and Bank Account number mentioned thereon
NOTES

In the event of death of the Life Insured prior to claim intimation, the relevant forms/documents are to be filled/provided by Nominee/ Claimant under the policy

Photocopies of documents should be attested by a Reliance Nippon Life Insurance Official.

The Insurance Company reserves the right to ask for additional documents/information

  • FAQs
  • Process

FAQs

 

 

Process

Health Claims

Cashless Claims

  • Claim Intimation - Inform the TPA appointed by RNLIC about your hospitalization (planned/emergency).
  • Claim Processing – The TPA co-ordinates with the hospital to process the request for Authorization of Treatment and communicates the approval / pre-authorization in line with the policy terms and conditions.
  • Claim Decision - The TPA will co-ordinate with the Hospital for settlement of the bills to the extent of authorization at the time of / after discharge.

Reimbursement Claims & Wealth + Health Claims

  • Claim Intimation – Send the Claim Forms, duly filled along with all supporting documents (in original as required) to RNLIC / TPA office at the earliest, preferably within 15 days of discharge.
  • Claim Processing – TPA will review the claim documents and inform you in case of any additional requirements through letters / SMS.
  • Claim Decision – On receipt of all necessary claim documents, the claim decision will be taken in line with the policy terms and conditions.

Cancer Protection Plus

Step 1: Claim Intimation and Submission of Supporting Documents

  • At all the RNLIC Branch Offices.
  • Directly to Claims Team at RNLIC Goregaon, Mumbai Office.

Step 2: Claim Assessment and Requirement for Additional Documents, if any

  • Claim documents and supporting documents will be scrutinized for completeness and adherence to policy terms and conditions.
  • Additional documents, if any, will be triggered and communicated to claimants.
  • Dedicated Team to handle the claims and provide assistance to the Claimant through dedicated, toll-free Claims Helpline.

Step 3: Claim Decision and Payout

  • On receipt of complete documentation, claim decision (in line with policy terms & conditions) will be informed to the claimants and approved claims will be processed for Payout.
  • For speed and ease, subject to availability of valid bank details, claims will be settled through electronic mode such as NEFT.
  • Else, the payment will be sent vide an Account payee Cheque at the customers’ address registered with the Company.
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