Health insurance Reimbursement claim
“A reimbursement claim in health insurance ensures that financial support follows medical care—pay first, claim later, and let your policy take care of the rest..”
Treatment at any Hospital – The Policyholder/Insured can get treatment at any hospital, whether in Galaxy Health Insurance network or not.
Pay Medical Bills – The Policyholder/Insured must settle the hospital bills, including doctor’s fees, medicines, and other charges.
Collect Documents – Gather essential documents such as hospital bills, discharge summary, prescriptions, and diagnostic reports.
Submit the Claim – Send the required documents to Galaxy Health Insurance within 15 days from the date of discharge.
Claim Review – Galaxy Health Insurance verifies the documents, checks policy coverage, and assesses claim eligibility.
Approval & Reimbursement – If approved, Galaxy Health Insurance transfers the eligible amount to the Policyholder/Insured bank account.
Reimbursement Claim Process
1
Claim intimation via toll free no. or Email to be given within 24hrs of hospitalization or before discharge
2
Policyholder/Insured taken treatment and paid the hospitalization bill
3
Submission of the original claim documents to nearest Galaxy Health Office within 15 days of discharge
4
Scanning and uploading of the claim documents
5
Claim processing as per policy terms and conditions
6
Approval / Query / Rejection
| Steps | Process |
|---|---|
| 1 |  The Policyholder/Insured member can receive treatment at a network or non-network hospital |
| 2 |  The Policyholder/ Insured shall notify Galaxy Health Insurance Customer Care team about the hospitalisation details via call or email |
| 3 |  The Policyholder/Insured shall pay upfront for the expenses incurred during the hospitalisation |
| 4 |  Policyholder/Insured shall submit documents in original pertaining to the hospitalisation along with the duly signed claim form to the nearest Galaxy Health Insurance office or agent |
| 5 |  Galaxy Health Insurance shall provide an acknowledgement to the Policyholder/Insured upon receipt of the claim documents |
| 6 |  Galaxy Health Insurance Claims team shall evaluate the claim based on the policy terms and conditions |
| 7 |  If the claim is admissible, Galaxy Health Insurance will process the claim and the reimbursement of hospitalisation expenses. The approved claim amount will be credited to the Proposer's account |
| 8 |  If the claim is not admissible, the reason(s) for rejection of the claim will be communicated to the Policyholder/Insured |
| 9 |  If any additional information or records are needed, Policyholder/Insured may submit these documents to the nearest Galaxy Health Insurance office or agent |
| 10 |  The Policyholder/Insured shall be informed of the claim status at every stage through SMS / email |
The reimbursement claim is to be supported with the following documents in original and submitted within 15 days from the date of discharge
Duly filled in claim form with treating doctor’s signature
Pre/Post Hospitalisation investigations and treatment papers
All investigations reports including Radiological films (Xray, CT scan, MRI and USG) and Biopsy reports pertaining to the hospitalisation
Discharge Summary from the hospital
Cash receipts from hospital, chemists
Cash receipts and reports for tests done
Receipts from doctors, surgeons, anaesthetist
Certificate from the attending doctor regarding the diagnosis
KYC (Identity proof and Address proof) of the proposer, as per Anti Money Laundering Guidelines
Copy of PAN Card
CKYC No. of the proposer (if available)
NEFT documents viz., Customer name, Bank Account No., Name of the Bank, IFSC code
Legal heir/succession certificate, wherever applicable
Ensure all documents are properly organized and submitted within the insurer's specified timeframe to avoid delays or rejection
Disclaimer
The content provided on this website is for informational purposes only and does not constitute an offer to sell or a solicitation of an offer to buy any insurance products. Health insurance policies and plans are subject to underwriting and approval by Galaxy Health Insurance. The terms, conditions, exclusions, and benefits of each policy may vary based on disclosure by the prospect and plan selected.
For more details on terms and conditions please read the sales brochure carefully.
