Claim Reimbursement Requirements

  IPD Claims

  • IPD Claim Form Original (Completely Filled)
  • Hospital Payment Receipts/Bill Original (Details of payments being charged should be mentioned on the
    receipt/bill i.e. break‐up of payment)
  • Doctor`s Notes or Discharge Slip/Card/Summary Original(Mentioning Chief Complaints, diagnosis, course of treatment along with other hospitalization details)
  • Hospital Intimation Form Original (Faxed form showing estimate approval by SICL‐Health Department)
  • Medicine Receipts Original (Purchased during IPD, Pre/Post Hospitalization Treatment)
  • Investigation Reports if any Original
  • Birth Certificate for maternity cases where live baby is born Copy (Proper printed certificate with Hospital/
    clinic insignia Completely filled and attested by a gazetted officer)
  • Shaheen Health Card & National Identity Card Copy (They should be valid at time of presentation)

Note

  • Kindly photocopy all claims being sent to our office and maintain them in your record for future reference.
  • No Overwriting or Additional Changes to already prescribed prescriptions/receipts is allowed.
  • No Prescriptions/Receipts are allowed to be claimed on blank papers having no title of the chemist/doctor/hospital.
  • For pediatric vaccination cases, attach photocopy of ` Immunization Schedule/Chart` attested by gazette officer.
  • For continuous medication, attach photocopies of doctor prescription showing brief history, diagnosis, medicine advised mentioning long term use with every medicine claim related to this prescription(this doctor prescription is valid for 3 months after which follow‐up(new prescription) is required according to WHO `health for all` program).
  • `Hospital Intimation Form` is exempted for clients having an emergency or a condition where there is threat to human life i.e in case the treatment is not provided instantly, when Shaheen Health Department is closed but Intimation approval should be taken from Shaheen Health department as soon as possible on the next working day.
  • For Panel Hospitals(If it`s holiday/Non‐working Day), in case of emergency, the patient can be treated or hospitalized instantly as per requirement of patient after assessment by Doctor with security deposit from patient (for 1 day treatment or as required) which will be refundable after receiving a `Hospital Intimation Form` approval from SICL on the next working day according to the approved amount.
  • To avoid delays, for IPD cases, seek approval of estimate amount via `Hospital Intimation Form` before admission.
  • All medicine cost/bills incurred will be checked with rate lists provided to us via hospital/clinics and chemists(Rate lists updated every 15 days)
  • Claims presented after 15 days of expiry of policy period will not be re‐imbrued.
  • OPD claim expenses incurred should be claimed within 3 months and IPD claim expenses incurred within 1 month.
  • In case of lack of documents submitted for claim re‐Imbursement, they should be submitted within 1 month after receiving letter for their submission or the claim will stand refused/rejected after expiry of period of 1 month.