Claims Assistance Desk

1. Show your Health Insurance Card / Policy Number at the hospital TPA desk. 2. The hospital TPA sends a pre-authorization form to the insurer. 3. Intimate Family Shield Insurance via call or WhatsApp (+91 92256 32920). 4. Our advisor follows up directly with the TPA medical auditor for cashless clearance within 12 to 30 minutes.

Don't panic! Rejection of initial cashless pre-authorization does NOT mean your claim is rejected. It often happens due to missing past medical history documents or missing doctor diagnosis notes. Contact Family Shield Insurance immediately — we review the TPA query letter and upload the required medical evidence to convert it into approved cashless status.

Standard policies exclude non-medical consumables such as gloves, PPE kits, admission kit fees, food for attendants, and administrative charges. At Family Shield, we audit your final hospital bill item-by-item to prevent hospitals from wrongly coding covered medical items as non-payable consumables.

Most health insurers require reimbursement claim files (with original discharge summary, itemized bills, pharmacy receipts, and diagnostic reports) to be submitted within 30 days from the date of discharge. Pre and post-hospitalization bills can be submitted within 60 to 90 days.

Under IRDAI regulations, uncomplicated life insurance claims must be paid within 15 to 30 days of receiving all complete claim documents. For policies held continuously for over 3 years, Section 45 of the Insurance Act prohibits insurers from repudiating claims except in cases of proven fraud.

If your claim is unfairly repudiated, we draft an official representation with clinical evidence to the Insurer's Grievance Redressal Officer (GRO). If required, we represent your case before the IRDAI Insurance Ombudsman desk in Pune/Mumbai for binding resolution.