Claims FAQ

Policy number; policyholder and insured person names; nature of illness/treatment; hospital name/address; admission date; estimated expenses.

Initial response within 1 hour of receiving all documents; final approval within 3 hours of discharge request.

We will request missing information; once complete, we’ll process the request as per the policy terms and conditions.

Under our “cashless everywhere” initiative we may extend cashless to non‑network hospitals; otherwise, you pay and file for reimbursement.

Completed claim form; photo ID/age proof; intimation reference; discharge summary; hospital bills; diagnostic & pharmacy bills; implant invoices; pre/post hospitalization reports; MLC/FIR for accidents; death summary/certificate if applicable; KYC documents, etc

Send originals to: Claims Department, Narayana Health Insurance Ltd, No. 261/A Bommasandra Industrial Area, Bangalore 560099

We aim to settle valid reimbursement claims within 15 days of receiving complete documents.

We’ll send up to three reminders for missing docs; if still not received after 45 days, we may reject or part‑settle the claim.

If payment is delayed beyond prescribed TAT, we pay interest at 2% above the bank rate from document receipt to payment date

Yes—provide a written explanation; we’ll review delays beyond your control on merits.

Email support@narayanahealth.insurance or call +91 98210 34071 quoting your claim reference.

We’ll send reasons in writing within 15 days of receiving last documents; you can appeal or escalate to grievance@narayanahealth.insurance

No—claims are capped only by your sum insured; you can claim multiple times until the limit is exhausted

Yes, up to the period specified in your CIS; submit bills within 15 days from the discharge date.

Yes, for the period defined in your policy; include these bills in your reimbursement submission. Submit bills within 15 days from the completion of post-hospitalization period.

Submit original implant stickers and invoices (e.g., stents, lenses) with your claim documents

Yes—for cashless, we send it to you for signature to retrieve hospital records and invoices if required.

Same process—plus provide MLC/FIR copy to support your accidental claim.

We complete any necessary investigation within 15 days and settle within 30 days of full documentation.

Our representatives may inspect medical and hospitalization records to verify claims.

Write to support@narayanahealth.insurance or escalate to grievance@narayanahealth.insurance; if unresolved.

Yes—listed day‑care treatments in your CIS are covered under cashless or reimbursement.

We pay directly to network hospitals for cashless; reimbursements go to your bank account as per your claim form details.

Update your bank info by emailing support@narayanahealth.insurance so payments reach you correctly

Only if they pertain directly to pre/post hospitalization and include practitioner’s prescription and invoice.

Email support@narayanahealth.insurance or call +91 98210 34071 (1800 203 0234 for senior citizens); for escalations, use grievance@narayanahealth.insurance.

A minimum 24‑hour hospitalization is generally required to file a claim; however, this may not apply for daycare treatments.

No—pre‑existing conditions are subject to a waiting period of up to 36 months. However, if our underwriting team has given a waiver for pre-existing diseases, those conditions are covered from day one.

Yes, specified daycare procedures that don’t require 24 hours stay are covered if listed in your policy.

Yes, ambulance charges are reimbursable up to the sub‑limits specified in your policy terms.

AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, Homeopathy) are covered if taken in a government or IRDAI‑approved hospital under hospitalization.

Claims for a continuous illness (including relapses within 45 days) are treated as a single claim under your sum insured.

Expenses incurred for harvesting and transplanting an organ from a donor to the insured are covered, including pre‑ and post‑operative care, provided the procedure is medically necessary and performed in a network or approved hospital

Treatment of congenital internal diseases is generally subject to a waiting period (typically 2 – 3 years) before you can make a claim.

Any sub‑limits (e.g., room rent, ICU charges, specific procedures) are applied per policy terms; expenses beyond these are payable by the insured.

In‑patient treatment for mental illnesses is covered under hospitalization benefits, subject to overall limits and sub‑limits as per your policy.