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Health Claims

Claim Process

At Liberty General Insurance, we offer quick and hassle-free claims process through our appointed Vipul Med Corp TPA. We are not only committed to your claim is settled at the earliest but also guide you and be by your side at times when you need us the most.

How do I register a claim?

If in case you need to register a claim please follow the below options to ensure your claim immediately attended:

  • Call at our Toll Free Number 1800 102 7477 (between 8:00am to 8:00pm, 7 days of the week)
  • Mail us on claims@vipulmedcorp.com
  • Send a written claim intimation letter to our appointed TPA or the applicable branch office by post or courier. Locate a Vipul Med Corp TPA branch ​next to you.

Our TPA representatives will then soon get in touch with you and guide you through the claims process.

Please intimate our appointed TPA at least 48 hours prior to planned hospitalisation and in case of an emergency situation, intimate us within 24 hours of post hospitalisation.

For a detailed overview of the claims process, please refer to our the Claims Guide Booklet​​ document.

Document List

Here is an indicative list of documents required for all kinds of claims:

  • In-patient Treatment/Daycare Procedures
    • Duly filled and signed Claim Form.
    • Photocopy of ID card / Photocopy of current year policy.
    • Original Detailed Discharge Summary / Day care summary from the hospital. Original consolidated hospital bill with bill no. and break up of each Item, duly signed by the Insured.
    • Original payment Receipt of the hospital bill with receipt number
    • First Consultation letter and subsequent Prescriptions. Original bills, original payment receipts and Reports for investigation supported by the note from the attending Medical Practitioner/ Surgeon demanding such test.
    • Surgeons certificate stating nature of Operation performed and Surgeons Bills and Receipts
    • Attending Doctors/ Consultants/ Specialist's/ Anesthetist Bill and receipt and certificate regarding same
    • Original medicine bills and receipts with corresponding Prescriptions.
    • Original invoice/bills for Implants (viz. Stent /PHS Mesh/ IOL etc.) with original payment receipts.
    • Hospital Registration Number and PAN details from the Hospital
    • Doctors registration Number and Qualification from the doctor
  • Road Traffic Accident
    In addition to the In-patient Treatment documents:
    • Copy of the First Information Report from Police Department / Copy of the Medico-Legal Certificate.
  • In Non-Medico legal cases
    • Treating Doctor’s Certificate giving details of injuries (How, when and where injury sustained)
  • In Accidental Death cases
    • Copy of Post Mortem Report (if conducted) & Death Certificate
  • For Death Cases
    In addition to the In-patient Treatment documents:
    • Original Death Summary from the hospital.
    • Copy of the Death certificate from treating doctor or the hospital authority.
    • Copy of the Legal heir certificate, if the claim is for the death of the principle insured.
  • Pre and Post-hospitalisation expenses
    • Duly filled and signed Claim Form.
    • Photocopy of ID card / Photocopy of current year policy.
    • Original Medicine bills, original payment receipt with prescriptions.
    • Original Investigations bills, original payment receipt with prescriptions and report.
    • Original Consultation bills, original payment receipt with prescription.
    • Copy of the Discharge Summary of the main claim.
  • Ambulance Benefit
    • Duly filled and signed Claim Form.
    • Photocopy of ID card / Photocopy of current year policy.
    • Original Bill with Original Payment Receipt.
    • Treating Doctor’s consultation prescription indicating Emergency Hospitalization.
    Insurance is the subject matter of the solicitation.
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    Call Toll Free No : 1800 266 5844
  • Reimbursement of Organ Donor Expenses
    In addition to the documents of general hospitalization
    • Organ Function test / blood test proving organ failure.
    • Treatment Certificate issued by the Transplant Surgeon of the hospital concerned.
  • Hospital Cash Allowance- Same as In-patient Hospitalisation treatment
  • Restoration/Reinstatement of the Sum Insured- Same as In-patient Hospitalisation treatment
  • Recovery Benefit- Same as In-patient Hospitalisation treatment
  • Nursing Allowance- In addition to the In-patient Treatment documents:
    • Duly signed prescription for Private Nursing requirement and its necessity from the treating Medical Practitioner
    • Original Bill with Original Payment Receipt of Nursing charges from the utilized Nursing Burrow/Private Nurse
  • We may call for additional documents/ information as relevant to the claim.
    Applicable to all claims under the policy:
    • In the event of the original documents being provided to any other Insurance Company or to a reimbursement provider, the Company shall accept verified photocopies of such documents attested by such other Insurance Company/ reimbursement provider.
  • Claim Document Master
  • Claim Processing Instruction
  • Download Health Card
  • Claim Forms

FAQ's

How can I indemnify or claim benefits under the policy?

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The expenses or benefits can be claimed or indemnified either by reimbursement or by availing cashless services at our empanelled hospitals. Click here to know the complete claims process.

Is cashless facility available across all hospitals?

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The cashless facilities are available only at the hospitals which are in our network. Please click here to see our complete of hospital network.

How do I register a cashless claim in case of emergency?

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Cashless claims facility is available only with the network hospitals of our associate Third Party Administrator (TPA). You need to ensure that the chosen hospital belongs to our network. Click here to find out our network hospitals.

Step 1: Within 24 hours of admission, inform our TPA at their Toll Free helpline number 1800 102 7477. For Senior Citizens, intimate the TPA at the Senior Citizen Toll Free helpline number 1800 180 1166. Please do quote your Membership Number provided on your health card.

Step 2: Fill the first section of cashless claim request form available with the Hospital at their Insurance/TPA Help Desk and hand over the signed Pre-Authorization form to the Hospital's Insurance/TPA desk for them to fill up the balance details. The cashless claim request form is also available on our TPA’s website (www.vipulmedcorp.com) and our website (www.libertyinsurance.in/customer-support/download-forms).

Step 3: The cashless claim request form along with the required medical records is to be faxed to the TPA by you / Hospital to initiate the process.

Step 4: The TPA will conduct a preliminary scrutiny of the documents and convey the decision on eligibility for cashless claim to the hospital. The TPA could sanction the cashless claim request or call for additional documents, if required.

For a detailed look at the cashless claims process, please click here

What preliminary information is needed for claim intimation?

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Following information is required for claim intimation:

  • Policy Holder's Name
  • Membership Number & Policy Number
  • Hospital details
  • Diagnosis and Treatment details
  • Approximate claim amount
  • Date of admission

What is the cashless claims procedure in case of a planned admission?

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Cashless claims facility is available only with the network hospitals of our associate Third Party Administrator (TPA). You need to ensure that the chosen hospital belongs to our network. Click here to find out our network hospitals.

Step 1: Atleast 48 hours prior to admission, inform our TPA at their Toll Free helpline number 1800 102 7477. For Senior Citizens, intimate the TPA at the Senior Citizen Toll Free helpline number 1800 180 1166. Please do quote your Membership Number provided on your health card.

Step 2: Fill the first section of cashless claim request form available with the Hospital at their Insurance/TPA Help Desk and hand over the signed Pre-Authorization form to the Hospital's Insurance/TPA desk for them to fill up the balance details. The cashless claim request form is also available on our TPA’s website (www.vipulmedcorp.com) and our website (www.libertyinsurance.in/customer-support/download-forms)).

Step 3: The cashless claim request form along with the required medical records is to be faxed to the TPA by you / Hospital to initiate the process.

Step 4: The TPA will conduct a preliminary scrutiny of the documents and convey the decision on eligibility for cashless claim to the hospital. The TPA could sanction the cashless claim request or call for additional documents, if required.

Step 5: On approval of cashless claim eligibility by the TPA, hospital bills will be settled directly (subject to policy limits and other terms & conditions) by us. Any inadmissible amounts like telephone charges, food charges, attendant charges etc., will have to be settled by you directly with the hospital.

Step 6: If the cashless claim eligibility is not approved by the TPA, please settle the bill fully with the hospital and apply for reimbursement claim as per process outlined here (hyperlink to claims page).

What is a reimbursement claim?

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If you have not availed of the cashless claims facility in our network hospital or you have taken treatment in a hospital which is not a part of our network, then all the medical treatment bills need to be first settled by you with the hospital and then submitted to our TPA for claiming a reimbursement. Please click here to know the complete process of reimbursement claims.

What is the maximum time allowed to file reimbursement claims?

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From the date of discharge, the claim needs to be filed within a maximum of 15 days with our TPA. Please click here to know the complete process of reimbursement claims.

What documents are to be submitted in case of a reimbursement claim?

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Below is the list of indicative documents which need to be submitted in case of a reimbursement claim. Please note that the TPA or the company is fully authorized to ask for more documents basis the nature of claim.

  • Claim form duly completed in all respects
  • Original Bills, Receipt and Discharge certificate / card from the Hospital.
  • Original Cash Memos from Hospital(s)/Chemist(s), supported by proper prescriptions.
  • Original Receipt and Pathological test reports from a Pathologist supported by the note from the attending Medical Practitioner / Surgeon demanding such Pathological tests.
  • Surgeon’s certificate stating nature of operation performed and Surgeons’ original bill and receipt.
  • Attending Doctor’s / Consultant’s / Specialist’s / - Anesthetist’s original bill and receipt, and certificate regarding diagnosis.
  • Medical Case History / Summary.
  • Original bills & receipts for claiming Ambulance Charges
  • Any additional documents or information, as may be deemed necessary by the Company or TPA.

Should the claim be submitted to Liberty General Insurance or to the Third Party Administrator (TPA)?

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The claim documents should be submitted to the TPA, mentioned on your health card(s).

If I avail cashless facility, will you pay the entire amount or will I be required to bear part of the bill at the hospital?

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Yes, we will pay the entire admissible amount for the medical expenses incurred subject to the maximum sum insured amount. You might have to pay for the non-medical and expenses not covered to the hospital prior to your discharge from hospital.

In case of cashless treatments, in whose favor are cheques settled or who gets the payments?

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The cheques are sent to the hospital to whom approvals for cashless are given.

Who is your Health TPA?

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Vipul MedCorp TPA Pvt. Ltd. is our appointed TPA. Vipul MedCorp TPA Pvt. Ltd, a company promoted by Vipul group is engaged in the managed healthcare facilitation & has obtained a license from IRDA for TPA activities (Health) and offers its clients a wide array of services.

Vipul MedCorp TPA Private Limited
515, Udyog Vihar Phase V
>Gurgaon, Haryana – 120016
Toll free number - 1800 102 7477
Website: www.vipulmedcorp.com

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