How to File A Claim with Max Bupa Health Insurance?

At Max Bupa Health Insurance you can be assured that your claims are handled at the earliest. Max Bupa has a claim ratio of 90 percent and has been awarded the 'Most Trusted Health Insurer' 3 years in a row. About 4,500+ network hospitals are available that offer cashless benefits for hospitalisation. 

Filing Claim with Max Bupa Health Insurance 

Max Bupa helps its clients to resolve their cases by either cashless treatment or reimbursement services.

1. Cashless Claims 

Step 1: Get admitted to the hospitals within Max Bupa’s network.

Step 2: The network hospital will then check your identity and give the “pre-authorisation request”.

Step 3: Use the Max Bupa Health Card/share the policy number at the hospital along with your identity proof -Passport/PAN card/Voter ID.

Step 4: Max Bupa will check and give their confirmation via fax/e-mail to the hospital after validation. Via text messaging/email, they ensure you are too notified of the same. Within 30 minutes of the claim filing, Max Bupa responds to your “claim request”.

Step 5: After fulfilment of the required formalities, the claim is settled with the hospital.

2. Reimbursement Claims 

Step 1: Contact Max Bupa within 48 hours of admission to their network/non-network hospital if you are hospitalised. Pay the amount directly to the hospital, after being admitted.

Step 2: Ensure you have all the relevant documents/invoices/medical history/discharge certificate with you when you are leaving the hospital. To process your refund, they will require the originals of all the documents mentioned.

Step 3: Send them all the documents with the claim form duly filled and signed. Give your ID proof of ID & age proof. The claim form can be accessed from the company website/policy document

Step 4: Your claim is checked after getting the documents and accordingly they give their approval, raise a claim, or deny the same. 

Step 5: If accepted, they will settle the claim and reimburse the “approved amount” 

3. OPD Reimbursements 

If you intend to reimburse an OPD claim, make sure that the OPD facilities from the list of doctors/clinics that have already been impanelled within Max Bupa's network are used. Keep a copy of a bill provided by the doctor/clinic that is valid. 

Step 1: Log in to "My Account" and click on "Raise a claim" under the "My Account" under the "OPD tab".

Step 2: To look for the doctor, enter the details in the "search section"

Step 3: Fill up the claim form by correctly entering bill details, bank details and uploading the listed documents before submitting it

Step 4: They would review the claim based on the information shared by you. They would then accept it, submit a request or deny the same

4. Diagnostic Centre Reimbursements

Step 1: Ensure you have a valid copy of the bill with you to make a diagnostic claim.

Step 2: Login to “My Account” and click on “Reimbursement claim” under the "My Account" section under the “annual health check-up page”.

Step 3: Enter the relevant bill information, bank details and upload the listed documents to complete the claim form. Submit it

Step 4: Based on the information shared by you, they would review the claim. They would then accept it, submit a query or deny the same.  

Conclusion 

Max Bupa Health Insurance is a well-known health insurance firm devoted to offering seamless procedures for insurance claims. The insurer resolves the claim as per the contract terms and conditions with a wide number of network hospitals across the country. Max Bupa is known for its cashless premium pre-authorisation in 30 minutes and immediate resolution of claims without the need for a third party. 

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.