If you pay a hospital bill yourself and need your insurance company to pay you back (this is called reimbursement), you must provide proof. The insurance company requires a very specific set of papers.
The biggest reason people get delayed is that they miss one of these documents. You need to keep every piece of paper the hospital gives you to build your "Claim Kit."
Here are the 7 required documents you must gather for a fast reimbursement:
1. The Claim Form
This is the application form from your insurance company. You must fill it out completely and sign it. The hospital usually needs to stamp and sign a section as well.
2. Original Hospital Bills
You must submit the final bill and every individual bill you received from the hospital. The company needs the original copies (not just photocopies) to check the total amount you paid.
3. Detailed Itemized Breakup
This is a complete list from the hospital showing the cost of every single item, such as room rent per day, every medicine used, all lab charges, etc. The company needs this to verify all costs.
4. Discharge Summary
This is the official document you get when you leave the hospital. It states why you were admitted, the treatment you received, and the dates of your stay. This confirms the entire treatment period.
5. Doctor’s Papers and Test Reports
You need the original prescription from the main doctor and all reports from any tests done, like X-rays, blood tests, or scans. This links the medical reason to the bills.
6. Payment Proofs (Receipts)
You must show proof that you paid the money to the hospital. This includes the payment receipts from the hospital or bank statements showing the transaction.
7. FIR or Legal Certificate (Only for Accidents)
If your hospital visit was due to an injury from an accident (like a car crash or a major fall), you must provide a copy of the official police report (First Information Report or FIR). This is necessary to confirm the cause of the accident.