SBILifeHospitalCash

ClaimProcess

9 Any hospitalization must be intimated to E-Meditek TPA Services Ltd before the hospitalization in case of pre-planned hospitalization or within 24 hours in case of emergency. Information like Policy No, Name of Policy Holder, and Name of Insured Member/Life Assured hospitalized, Name and Address of Hospital with contact details, Date & Probable Duration of Hospitalization should be provided. 9 Claim can be intimated by the Policy Holder / any insured member/any family member by calling the TPA call center Helpline toll no : 1800 102 3242, giving basic information as given in the above point 9 The TPA will provide a Reference no which should be noted on the Claim Form to be submitted after hospitalisation 9 After the Hospitalization, Claim has to be registered with E-Meditek TPA Services Ltd within 30 days of Discharge from Hospital 9 How to obtain the claim form? TPA call center: Please call the TPA Helpline toll No: 1800 102 3242 and inform them of the claim. The claim form will be couriered to your registered address. In case your address has changed, please inform the changed address on phone Download the claim form from the SBI Life website- www.sbilfe.co.in or E Meditek website-http://emeditek.co.in . Collect the claim form from the nearest branch of E-Meditek/Sbilife (Addresses are available on the website). 9 Documents to be submitted along with the claim form Copy of policy document. Hospital cum Treating doctors certificate Discharge card and copy of all medical documents/Reports related to hospitalization Identity proof of the policy holder Age proof of the insured member / Life Assured PAN card copy of the Policy Holder (for online policies) Direct Credit Mandate of the Policy Holder Any other document as the TPA/Company may require depending on type/cause of claim * All the above documents must be self-attested by the Policy Holder

9 The claim form along with the above mentioned documents should be sent to the following address: E-Meditek (TPA) Services Ltd, 208-209, Turf estate, Off Dr E Moses Road, Near Mahalaxmi Station, Mahalaxmi, Mumbai 400011 9 On receipt of the completed claim form along with the required documents E- Meditek will acknowledge your claim through an auto SMS and /or auto mail provided the mobile number and/or mail ID is available 9 E-Meditek will process your claim and respond to you within 15 days from the date of submission of all the documents 9 Grievance Redressal If you are dissatisfied with the services of E-Meditek, please contact Head Office E-Meditek (TPA) Services Limited #45, Nathupur Road DLF Phase III Gurgaon, Haryana -122002

If E-Meditek is not able to redress your grievance, please contact Head Claims Central Processing Centre Kapas Bhavan, Plot No; 3A Sector-10, CBD Belapur, Navi Mumbai -400614

Conditions for Hospitals for Hospital Cash policy

9 Hospital has to be registered with appropriate authorities 9 Hospital is established in India and must be offering allopathic treatment 9 It is under the supervision of a registered and qualified physician 24 hours in a day 9 Hospital maintains a daily medical record for each of its patients 9 Hospital should have the following facilities : a. Minimum of 10 inpatient beds b. Fully qualified nursing staff under the employment of the Hospital 24 hours a day c. A fully equipped operation theatre of its own where surgical operations are carried out 9 The following institutions are excluded from the definition of Hospital even if it is registered as a Hospital or nursing home: a. A rest home or a convalescent facility b. A place for custodial care c. An old age home d. A place for treatment of alcoholic or drug addicts or treatment of psychiatric or mental disorders Meaning of ICU for the purpose of Hospital Cash Policy 9 A designated section of the hospital which is under the constant supervision of a specialist 9 Specially equipped for treatment of patients in critical condition 9 Life support facilities are available 9 Level of care and supervision is more intensive than in other wards of the Hospital