Health Claim Reimbursement: Documents and Deadlines

Filing a health insurance reimbursement claim

In short: In a reimbursement claim you pay the hospital first and claim the money back from the insurer. Inform the insurer on time, keep every original bill and report, and submit the claim form with your documents within the deadline in your policy, which is often 30 days from discharge.

When you need a reimbursement claim

Treatment at a hospital outside the insurer’s network.
A cashless request that was denied or only partly approved.
Pre- and post-hospitalisation expenses, such as tests before admission and medicines after discharge.

Documents to keep and send

The signed claim form, and a copy of your policy or health card.
Photo ID and KYC documents of the policyholder.
Discharge summary.
Final hospital bill with an item-wise breakup, and the payment receipts.
Pharmacy bills with the matching prescriptions.
Test and investigation reports.
Doctor’s consultation notes or certificates.
A cancelled cheque or bank details for the payment.
For accidents, the FIR or medico-legal certificate if one was made.

Time limits to watch

Informing the insurer. Your policy sets a time limit, often within 24 to 48 hours of an emergency admission, or before a planned one.
Submitting the claim. Usually within a set number of days after discharge, often 30. Post-hospitalisation bills have their own deadline after that period ends.
Late submission. Policies usually allow a delay to be excused for genuine reasons. Explain the reason in writing.

What to do, step by step

Inform the insurer or TPA as soon as the patient is admitted, and note the intimation number.
Collect originals at discharge. Ask the hospital for the itemised bill, discharge summary and all reports before you leave.
Submit a complete file within the deadline and keep a copy of everything, with proof of the date you sent it.
Track the claim and answer any query in one complete reply.
Escalate if the claim is delayed, cut or rejected. See delayed claims.

How Mediclaimswala helps

We check your file before it goes, so nothing is missing, and follow up until the money reaches you. If the claim is reduced or rejected, we take it up with the insurer.

Last reviewed: 15 November 2026. This page is general information based on IRDAI rules as of the date above. It is not legal advice. Policy wordings differ, so we check what applies to your case.

Questions people ask

What is the difference between cashless and reimbursement?

In a cashless claim the insurer pays the network hospital directly. In a reimbursement claim you pay the hospital and the insurer pays you back after checking your documents.

Can I claim reimbursement if my cashless request was rejected?

Yes. A cashless denial is not a final rejection of the claim. You can pay the hospital and file for reimbursement with full documents.

What if I miss the submission deadline?

Submit as soon as you can with a letter explaining the delay. Policies usually allow a delay to be excused for genuine reasons, such as the patient’s illness.

Should I send original documents?

Follow what your insurer asks for, and always keep a full copy of everything you send, with proof of the date.