Update: 20 March,2016
PROCESS FOR AVAILING CASHLESS FACILITY
In case of planned hospitalization obtain pre-authorization from TPA, 72 hours in advance which will facilitate your hassle free admission at the hospital.
Approach Network Hospital with copy of E-card & ID proof.
· Hospital shall send necessary details to TPA for pre-authorisation.
· Patient to be admitted and treatment administered to him/her.
· Patient to be discharged on
Completion of treatment.
· Patient to go home.
· Insurance Company will settle the bill
directly with the hospital.
PROCESS FOR AVAILING REIMBURSEMENT FACILITY
All claim documents in original need to be submitted to the pension paying Branch.
· Submit all prescriptions, bills, cash memos, Investigation reports etc. to pension paying Branch before 10th of every month
· Pension paying Branch to send all the papers to their respective Zonal Office.
· TPA to collect the requisite documents on daily basis from Zonal Office.
· TPA to scan the documents and intimate the insured conveying registration number of claim.
· TPA to settle the claim within 15 working days on receipt of documents and send approval note to United India Insurance Company for release of payment to the pension account of insured.
Where employee is unable to manage self service Branch Head / Recommending Authority/ designated official at LHO can apply on behalf of employee through a link available in ESS. A print out of portal submission will be taken, duly signed by the employee and will be submitted to next authority. ( Circular No.CDO/P&HRD-PPFG/84/2014-15 dated 23.02.2015)