Oriental Health Insurance Company

How to File a Oriental Health Insurance Claim?

The process of filing a claim online in your Oriental health insurance plan is very easy and can be done within minutes through PayBima. Follow the steps to file a claim for the Oriental Health plan: Locating the nearest network hospital

Oriental Insurance offers both cashless and reimbursement claims. To avail of the cashless claim facility, you will have to get admitted to one of the networked hospitals of the company. You can easily locate the nearest networked hospital through the website of the company. Then, show your health card and identity proof for admission to the hospital. Pre-authorization claim form

To get your cashless claim approved, you need to duly fill out and submit a pre-authorization claim form to the insurance company. Submission of pre-authorization claim form is the method of initiation of the claim. You can get the form from the hospital or you can also download the form from the website of the insurance company. Fill out the form with relevant details of the claim and then submit it at least prior 3-4 days before you are hospitalized. In the case of emergencies, however, the form can be submitted within 24 hours of hospitalization.

Cashless treatments

Based on the details filled in the pre-authorization form, the insurance company would provide you with the approval to avail of cashless claims. The company will communicate this to the networked hospital which would only after approval is received to proceed with the treatments and all the bills would be directly settled by the insurer.

Reimbursement claims

If you want to get admitted to a non-networked hospital or if your approval for the cashless claim has been rejected, your claim would be then settled on a reimbursement basis. In the reimbursement facility, you will have to clear all the bills initially which would be reimbursed by the insurance company later. You would have to intimate the claim to the insurer before your planned admission and in case of emergencies; you have an option to intimate the claim after the admission but before the discharge. After discharge from the hospital, fill up the claim form and submit all the medical bills, prescriptions, original bills, and receipts to the insurance company. The company would verify your claim and reimburse you for the expenses incurred for treatment.

You can also seek help from PayBima for easy claim settlements. Just dial 1800 267 67 67 or send an email to [email protected] and we will help you with your claims. For a successful claim settlement, certain documents are required to be submitted along with the claim form. These include –