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NonNetwork Provider Intimation

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Anuranjan Tirkey
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11 views2 pages

NonNetwork Provider Intimation

Uploaded by

Anuranjan Tirkey
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Acknowledgement of Intimation

Date : 10/07/2024
To,
ANURANJAN TIRKEY
H N -7/A STREET-38,SECTOR-7 CIVIC CENTRE, BHILAI
490006

Dear Sir/Madam,

We acknowledge receipt of the claim intimation and your claim intimation number is
INT1292807. Kindly quote this reference number in all your future communications.

To process the Reimbursement request, kindly submit the following documents at the insurance
desk of hospital.

List of documents needed

Duly filled in and signed health claim form (Claim form is available on website @ https://
www.tataaig.com/downloads -> Forms -> Claim - Personal Insurance -> Health)
Insurance card or Policy copy /Customer ID proof with photo
Medical certificate signed by the doctor/ Admission notes from treating doctor
Original discharge summary
Original consolidated final bill
Break up required for the submitted final bill
Cash paid receipts of hospital/pharmacy/lab
Bank details of payee (proposer) name printed on cancelled cheque / or Bank passbook
Investigation reports in support of the diagnosis
Previous OPD consultation papers with reports, if any
Previous discharge summary or any other medical records available with you
Any previously approved / settlement letter from Tata AIG for reference (optional)

Please Note:

In case of implants used, invoices are required.


In case of accidental injuries, MLC / FIR copy is required.
In case of death of main member, details of nominee (as per policy schedule), along with Pan
Card, address & ID proof of the nominee are required.
X-ray and CT films, do not sent, unless asked. Only reports required.
In case, claim value above Rs.1 lakh, duly filled in CKYC form with mandatory columns With
photograph of main member / proposer and cross signed on it is required.

Kindly submit the claims documents at the below-mentioned address:


Tata AIG Health Claims Hub,
Door No. 615, 616, 5th and 6th Floor
Imperial Towers, Ameerpet,
Next to Ameerpet Metro Station,
Hyderabad, Telangana - 500016

Kindly retain a copy of all documents being sent to us and quote your Claim Intimation ID
INT1292807 for future correspondence regarding the claim. On receiving the above mentioned
documents, we will process the claim based on its merits as per your policy terms and
conditions.

Tata AIG General Insurance Company Limited Page 1 of 2


In case of any assistance, kindly call us on our toll free number 1800 266 7780/ 1800 22
9966 (for Senior Citizen)or mail us at healthclaimsupport@tataaig.com
Thanking you, assuring you of our best services at all the times.

We wish you speedy recovery.

Yours Sincerely,
Tata AIG General Insurance Co. Ltd.
Authorized Signatory

Tata AIG General Insurance Company Limited Page 2 of 2

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