You have various modes by which you may contact the TPA i.e. E-mail/Toll free number/Walk-In details for details of number and e-mail id please refer to Contact us https://mdindiaonline.com/StaticPages/Static_HelpDesk.aspx

In case of any clarifications that may be required the policy holder can call the Insurance Company or the Third Party Administrator (TPA). In addition to this they can also check the policy documents and refer to the policy terms and conditions

When the policy is purchased from Insurance Company and a copy of policy is submitted to Third Party Administrator (TPA) you shall be issued with a MD ID cards. A physical MD ID card shall be delivered at communication address mentioned on policy documents

To have the policy renewed policy holder needs to approach an Insurance Company from where the policy had been issued

No. The MD ID card issued at the time of commencement of policy shall be valid up to the expiry of policy. The start date is mentioned on MD ID card and has no end date mentioned for the same reason.

No. For the first 30 days a Policy Holder cannot avail the benefits of Mediclaim under the policy purchased, however this clause may vary for different policies.

You need to approach to your Insurance Company or Third Party Administrator(TPA) call center number given in Contact Us click here https://mdindiaonline.com/StaticPages/Static_HelpDesk.aspx

You would be issued with a MD ID card from TPA also you will be having policy copy issued by Issuing Office by which identification would be done.

You may refer to Answer no. 11 & 12

Print Non Cashless Procedure:-

• Non Cashless/Reimbursement Toll free No: - 1800-209-7777 & 1800-209-7800
• Non Cashless/Reimbursement UAN No: - 1860-233-4446 & 1860-233-4448
• Non Cashless/Reimbursement E-mail id: - customercare@mdindia.com
• Policy Holder may visit any hospital for availing the Non cashless benefit provided that the hospital should meet the definition of “Hospital” as mentioned on policy document.
• Need to intimate the TPA within 24 hours or prior to hospitalization (Note: For IBA Policy holder intimation has to be done prior to hospitalization) via E-mail/Toll free/ Website.
• Click on the link below for the Intimation Form https://mdindiaonline.com/ClaimIntimationForm.aspx
• (Please Note - The revert time for each claim intimation submitted may vary depending on the policy terms and conditions)
• All original documents relating to the treatment need to be collected from the treating hospital.
• Post discharge the patient needs to submit all documents to the TPA for claim processing within 7 days from date of discharge (DOD) (Please Note – Document submission timelines for claim processing may vary depending on the policy terms and conditions)

List of documents:-

• Duly Filled & Signed Claim form by the Patient or Policy Holder (Part ‘A’ has to be filled by Policy Holder & Part ‘B’ has to be filled by treating Doctor) click here for claim form. https://mdindiaonline.com/StaticPages/Static_DownloadForms.aspx
• Original Hospital Discharge Card / Discharge Summary.
• Original Hospital Final Bill with the Seal & Signature of the Hospital.
• Detailed Hospital Bill Break-Up for the expenses.
• All original Prescriptions & Consultation Papers of the doctor.
• All original Medical bills with the Name of the Patient duly endorsed by the treating doctor.
• All original Cash Paid Receipts, Deposit Receipts supporting the bills in the name of patient.
• All original Medical Investigation Reports Certified, X-ray, MRI/CT Printed with black films by the doctor advice note.
• Summary of all Expenses.
• In case of accident Medico Legal Certificate (MLC) / FIR – If done & If Not – Self Explanatory Note about the accident in details has to be submitted.
• Duly filled ECS form click here for ECS Form. https://mdindiaonline.com/StaticPages/Static_DownloadForms.aspx with Original Cancelled cheque or Bank Passbook of employee bearing the IFSC Code and MICR Code.
• Acceptance for ECS Submission:-
  • ECS form & cancelled cheque to be submitted in favour of policy holder.
  • If Cancelled cheque is not available you may submit the copy of first page of passbook.
  • For corporate policies ECS details may differs ( it may be in the name of Corporate/Employee)
• KYC Documents (Need Residence & Id Proof like: - Pan Card, Passport, Voter’s Identity Card, Driving License, Aadhaar card etc.)
• The documents should be submitted to the nearest branch of MD India. Corporate policy holders need to submit the documents to their respective HR/any nearest branch of MD India.
• For HDFC Life Policy the claim documents have to be submitted to: “MDIndia Health Insurance TPA Private Limited Mediclaim Queries – HDFC Life 12th Floor, Lodha Excelus, Apollo Mills Compound, N. M. Joshi Marg, Mahalaxmi, Mumbai. - 400011”. Please Note - Age proof is mandatory while submitting the claim documents for HDFC policy holders.)
• For LIC Policy the claim documents have to be submitted at their respective OS Office only.
• For IBA policy the documents has to be submitted at Welfare Office
• On receipt of claim documents TPA will have the claim processed and will revert to client via E-mail/SMS.
• ADR (Additional Document Request) may be raised for clarification required while processing claim.
• Most commonly ADR requests raised are:-
  • ECS submission done in favour of Patient/Employee/Corporate/Beneficiary name differs
  • Exact claim amount with detailed break up
  • Original Discharge card to be submitted
  • Investigation reports if done any

Print Cashless Procedure:-

• Cashless Toll free No :- 1800-209-7800 & 1800-209-7777
• Cashless Fax No :- 1860-233-4449
• Cashless UAN No :- 860-233-4446 & 1860-233-4448
• Cashless E-mail Id :- authorisation@mdindia.com & contact@mdindia.com
• Need to visit Empanelled/Network hospital to avail cashless benefit.
• For Retail (Individual) Policy Holder willing to take treatments under the mentioned cities Pune, Mumbai, Chennai, Delhi, Hyderabad, Ahmedabad, Bangalore, Chandigarh, Haryana, Indore, Kolkata, Jaipur & Coimbatore, kindly click on the link to get the list of Network hospitals: https://mdindiaonline.com/ProviderList_PPN.aspx
• For Retail (Individual) Policy Holder willing to avail treatment from any other cities, please click on the link below for the list of Network hospitals: https://mdindiaonline.com/ProviderSearch.aspx
• For Corporate Policy Holder click on the link below for the list of Network hospitals: https://mdindiaonline.com/ProviderSearch.aspx
• The below documents need to be carried while visiting the network hospitals:-
  • Photocopy of current year policy (Not applicable for corporate policy holder)
  • MDID card
  • Valid photo-id proof (Driving license/Pan card/Passport/ Aadhaar Card/Voter Id etc.) of the patient
• Approach the TPA counter at the hospital and provide your MD ID or policy number.
• There will be a “Request for Authorisation Form” provided to be filled and signed.
• The hospital will enter the treatment and other relevant details and send the documents to TPA.
• On receipt TPA will have the cashless request processed and will revert to hospital & client via E-mail/SMS with the outward. A revert is sent within 2 to 4 hours from receipt of all the required documents.

You may visit any hospital provided that hospital should meet the definition of “Hospital” mentioned on policy documents

The packages for illness may vary in every hospital in case of Network Hospital where as in Preferred Provider Network list of Hospital the package rate would be the same in every hospital.

Pune,Mumbai,Chennai,Delhi,Hyderabd,Ahmedabad,Bangalore,Chandigarh,Haryana,Indore,Kolkata,Jaipur & Coimbatore are the cities which are covered under the Preferred Provider Network

Yes. The medical expenses incurred before hospitalization is known as “Pre-Hospitalization” & expenses incurred after hospitalization is known as “Post hospitalization”. As per the standard policy the Pre & Post Hospitalization Turnaround Time (TAT) is for 30 & 60 days which will be applicable as per the policy.

Yes you can check the status online, for login details call on our toll free number given in Contact us https://mdindiaonline.com/StaticPages/Static_HelpDesk.aspx

Yes. We have a mobile application named HAWK which needs to be downloaded from Google Play Store click here for application https://play.google.com/store/apps/details?id=com.mdid.hawk & Apple App Store click here for application https://appsto.re/in/UdYs-.i

No. The charges are not covered for regular health check ups

When the policy is renewed continuously without any claim reported under policy for certain years (Years will vary from policy to policy) there is a certain amount added up into your Sum Insured by Insurance Company which is known as Cumulative Bonus. It is applicable only for NIA (The New India Assurance Company) & NIC (National Insurance Company) Policy

It means Medical Treatment for a period exceeding for three days against such illness/disease/injury which in the normal course would require a care & treatment at hospital/nursing home as in-patient but actually taken at home in India under any of the following circumstances namely:-

• The condition of patient is such that he/she cannot be moved to the Hospital/Nursing home
• The patient cannot be moved to Hospital/Nursing home due to lack of accommodation in any hospital in that City/Town/Village

On the rejection of claim customer has to send the request for reconsideration of claim to TPA within 15 from the date claim is rejected/deducted against the claim amount