GIPSA, PPN and Empanelment in Health Insurance - Explained
GIPSA, PPN in GIPSA, Points to remember before opting GIPSA services, hospitals, empanelment
February 20, 2023
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Group health insurance claim forms download
A claim form in health insurance is a standard document provided by the health insurance company or the TPA. By filling this out, the policyholder or the insured can raise a claim to the health insurance company and claim the hospitalisation expenses.
The claim form comes into play when the insured has opted for a reimbursement claim. A reimbursement claim is where the insured pays out of his/her pocket for the hospitalisation expenses. After that, he/she applies for a reimbursement claim to the health insurance company.
The claim form has two parts, of which the first one is called the Claim Form Part - A and the second is the Claim Form Part - B. The first part is filled out by the policyholder and the second part is filled out by the hospital.
The insured/policyholder duly fills out the claim form part A.
This part of the claim form holds all the required information about the policy, details of the policyholder, details of hospitalisation, and others.
Let us see them one by one.
The claim for part B is the second part of the claim form. This is duly filled by the hospital where the treatment was taken. Hence, the policyholder need not worry about filling this part B of the reimbursement claim form.
The claim form, also known as the reimbursement claim form is provided by the health insurance company, the TPA, or by the IRDAI. The health insurance company provides the reimbursement claim form if the claim is to be processed by the internal TPA of the insurance company.
In case, the claim is being processed by the external TPA of the health insurance company, the claim form mentioning the TPA’s name can be used.
Then there is the IRDA claim form which is provided by the Insurance Regulatory and Development Authority. This claim form for health insurance can be used across any health insurance company or the TPA.
However, please note that all the details mentioned above about the claim form part A and B do not change with respect to the claim form. In other words, the details asked for in any claim form are universal.
The following are the necessary documents required to file a reimbursement claim for your group health insurance policy.
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