|» I have an I-card issued by your company. What are the benefits of this card?
This is your health card issued by us as we have been appointed by your Insurance Company to service your claim. This card entitles you to avail cashless services in any of the hospitals in our network. The process for availing the facility and the list of hospitals are detailed in the User manual sent to you along with the card. The network list is also available on our website. You may make any enquiry on our toll free number using the unique identification number (card number) issued to you on this card.
» What is the process of availing cashless facility in the hospital?
In case of a planned hospitalisation you need to inform us two to three days in advance by faxing us the pre-authorisation form (form on website) signed by the treating doctor. Your claim would be assessed in the light of the policy issued to you by your insurance company and a letter of authorisaion will be issued to the hospital authorising treatment. In case of an emergency the hospital will fax the pre-authorisation letter. Once the Authority letter has been sent to the hospital you need not pay at the hospital. Alankit will pay your hospital bills upto the amount authorized in the Authority Letter.
» What are the formalities that need to be done at the time of discharge in case of a cashless facility?
You need to sign your bills, fill up a claim form and sign the same, leave all your investigation/diagnostic reports and X-ray/ultrasound films etc. The hospital authorities will courier the documents to us for assessment and payment.
» If I avail cashless facility for my hospitalisation, how will I claim for my post Hospitalisation expenses?
You can file a claim for reimbursement of your Pre & Post hospitalisation expenses (30 days before date off admission and 60 days after the date of discharge) with Alankit Healthcare Limited.
» What are my rights and duties as a hospitalization policyholder?
As a hospitalisation policy holder you have certain rights and duties enumerated as under: Rights: You have a right to be treated in any duly registered hospital of your choice. You have a right to know the status of your claim and if your claim has been found admissible you have a right to be paid. You have a right to represent to us or to the insurance company in case you disagree on any matter. Duties: Your duty is to 1. Inform Alankit in case of an admission: (Intimate your claim,), 2. Provide complete and correct information as required by your treating doctor who would in turn provide the same to Alankit. Send all relevant documents to AHCL. Please quote your policy number/card Number.
» Where do I lodge my claim if I get treated in a non-network hospital?
You can lodge your claim at our office at 2E/21,Alankit House ,Jhandewalan extension, New Delhi – 110055. If your claim is found admissible it shall be paid within 7 days of receipt at our end.
» What does my mediclaim policy cover?
Your Policy covers hospitalisation expenses subject to hospitalisation being for a minimum period of 24 hours (with certain exceptions) and exclusions.
» What is an exclusion?
Certain diseases that are not covered under the policy as mentioned in the exclusion clauses are called exclusions.
» What is a thirty-day exclusion?
As per the exclusion clause 4.2 of the policy any disease contracted by the insured person within the first thirty days from the commencement date of policy is not payable unless proved by the panel of doctors that the insured could not have known of the disease before the commencement of the policy.
» What is a one-year exclusion?
In a standard mediclaim policy certain diseases are not payable in the first year of insurance cover. These diseases are payable after a 12 month of continuous cover, if they were not contracted before the commencement of the policy. These diseases are Cataract, Benign Prostatic hypertrophy, Hysterectomy for menorrhegia or fibromioma, hernia, hydrocele, congenital internal diseases, fishula in anus, piles, sinusitis and related disorders.
» Is dental treatment covered?
No, dental treatment of any kind is not covered unless requiring hospitalisation
» My wife’s EDD is on 29.12.03. My policy commenced on 12.5.03. Is her delivery covered?
No, treatment arising from or traceable to pregnancy or childbirth including cesarean section is not covered in a standard individual mediclaim policy.
» Whether treatment for AIDS is covered?
No, expense araising out of any condition directly or indirectly attributable to any syndrom or condition commonly called AIDS are not covered.
» Whether charges for diagnostic test etc. are also covered?
Charges for diagnostic test consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any ailment, sickness or injury are payable
» On hospitalization, what is the time frame for intimation to the TPA or the Insurance Company?
You are required to intimate the TPA or your insurer within 24 hours of hospitalization.
» What is the time frame for submitting your reimbursement claim after getting discharge from the hospital?
You are required to submit your reimbursement claim within 7 days from the date of discharge.