Health insurance claim 2 types — Cashless (network hospital) aur Reimbursement (non-network). Dono ka alag process. Documents complete rakho. ProWiderKart guidance deta hai. T&C applicable.
Claim reject na ho — sahi process follow karo. Free jaankari via WhatsApp. T&C applicable.
Free Jaankari — WhatsApp1. Network hospital identify karo
2. Insurance desk pe jao admit hote waqt
3. Policy card + ID do
4. Pre-auth form fill karo
5. TPA pre-auth deta hai (2-4 hours)
6. Treatment
7. Discharge pe insurer directly pay karta hai
Emergency mein 24 hours mein inform karo. T&C applicable.
1. Treatment karwao
2. Original bills, receipts, reports save karo
3. Discharge summary lo
4. Claim form fill karo (within 30 days typically)
5. Documents submit karo
6. Insurer review
7. Bank account mein settlement
T&C applicable.
Cashless: Insurance card, Photo ID, Referral letter (if applicable)
Reimbursement: Claim form, Original hospital bills, Discharge summary, Doctor's prescription, Diagnostic reports, Pharmacy bills, FIR (if accident)
T&C applicable.
❌ Non-network mein cashless claim mat karo
❌ Pre-existing conditions chhupao mat
❌ Waiting period mein claim mat karo
❌ Documents incomplete mat rakho
❌ Time limit miss mat karo
ProWiderKart guidance se claim smooth karo. T&C applicable.
Reimbursement route se. All documents save karo, 24-48 hours mein insurer inform karo. T&C applicable.
Written rejection reason maango. Doctor se detailed letter lo. Reconsideration request karo. T&C applicable.
Shortfall ka itemized reason maango. Unjustified cuts pe written representation karo. T&C applicable.
Most insurers ka online claim submission available. T&C applicable.
ProWiderKart guidance free mein deta hai — WhatsApp karo. T&C applicable.
Cashless claim ke liye: 1) Network hospital mein admit ho. 2) TPA desk pe jaao — policy card ya number do. 3) Pre-authorization form fill karo. 4) Insurer approve karta hai typically 2-6 hours mein. 5) Treatment lo — discharge pe sirf non-covered items pay karo. Tip: Admission se pehle TPA helpline call karo — pre-auth faster hoti hai.
Non-network hospital mein: 1) Sab original bills aur documents save karo — discharge summary, prescriptions, lab reports, payment receipts. 2) Insurer ko 24-48 hours mein written intimation do. 3) Claim form fill karo — insurer website pe available. 4) Documents courier/upload karo. 5) Typically 15-30 days mein settlement. Critical: Originals zameen pe nahi jaate — certified copies bhi chalti hain usually.
Documents incomplete mat chhodo. Pre-existing conditions policy lene waqt honestly declare karo. Waiting period mein claim mat karo. Room rent limit exceed mat karo without knowing proportionate deduction. Timely intimation mandatory hai — delay se claim reject ho sakti hai.
ProWiderKart insurance claim process mein guidance deta hai — but final claim approval aur settlement IRDAI-regulated insurer ki discretion par hai. Hum facilitator hain. Free jaankari available hai. T&C applicable.
Free Jaankari: Koi bhi sawaal ho — WhatsApp pe poochho ya call karo +91-98332-16954. T&C applicable.
ProWiderKart ek financial facilitation platform hai jo individuals aur businesses ko RBI/IRDAI-regulated financial institutions se connect karta hai — bilkul free mein. Hum direct lender, insurer ya payment processor nahi hain — hum ek trusted intermediary hain jo aapko sahi direction mein guide karte hain.
Step 1 — WhatsApp Karo: +91-98332-16954 pe message karo ya prowiderkart.com pe visit karo. Apni requirement batao — kya chahiye, budget kya hai, city kahan hai.
Step 2 — Free Jaankari: Expert se discuss karo — eligibility, options, sahi route. Koi pressure nahi, koi fee nahi. aapse koi fee nahi jaankari.
Step 3 — Documents aur Application: Minimal documents WhatsApp ya email pe. ProWiderKart aapko guide karta hai — kya submit karna hai, kaise submit karna hai.
Step 4 — Institution Connect: RBI/IRDAI-regulated institution process aage le jaata hai. Final approval, terms, aur delivery unki discretion par hai. T&C applicable.
RBI-regulated lenders, IRDAI-regulated insurers, aur payment gateway providers ka network. Tier 2 aur Tier 3 cities mein bhi smooth service — no physical office required. Hinglish mein guidance — easy to understand. Pan-India coverage. Jaankari fee: Zero. Always. T&C applicable.
Ek patient ne health claim file ki par woh reject ho gayi kyunki unhone policy lete waqt apni purani diabetes ki bimari disclose nahi ki thi. Insurer ne ise 'non-disclosure' maana. Agar unhone shuruaat mein hi honestly bataya hota, to thoda zyada premium lagta par claim approve ho jaati. Lesson: pre-existing conditions kabhi mat chhupao — short-term mein premium bachega par claim ke time poora paisa atak jaayega. Honesty hi sabse sasti insurance strategy hai.
Cashless claim sabse aasaan hai: network hospital mein admit ho, TPA desk pe policy details do, pre-authorization karwao, aur hospital seedha insurer se settle karega — aapko sirf non-covered items dene hote hain. Reimbursement tab use hoti hai jab non-network hospital mein ho: pehle aap pay karte ho, phir saare documents submit kar ke paisa wapas claim karte ho. Galti — admission ke time TPA ko inform na karna; cashless ke liye pre-authorization mandatory hai. Doosri galti — room rent limit ignore karna; agar aapki policy mein room rent cap hai aur aap mehnga room lete ho, to poori claim proportionately kam ho jaati hai. Hamesha apni policy ki room rent aur sub-limits pehle se jaan lo.
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| Type | Coverage | Best For |
|---|---|---|
| Health Insurance | Hospitalisation | Individuals, Family |
| Term Life | Death benefit | Earning members |
| Motor | Vehicle damage | Car/Bike owners |
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Regulatory sthiti. ProWiderKart IRDAI ke paas broker, agent, corporate agent ya web aggregator ke roop me registered nahi hai. Hum insurance ki solicitation, sale ya advice nahi karte — sirf jaankari dete hain aur aapki sahmati par aapko IRDAI-regulated licensed partner tak pahunchate hain. Quotation aur underwriting usi partner ka hota hai.
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Udaharan aur guarantee. Is page ke udaharan kalpanik hain. Approval, eligibility, claim, rate ya premium ka koi vaada nahi — sab licensed partner ke discretion par. Poori regulatory jaankari · editorial policy.
Cover lene se pehle ye sawaal khud se poochne chahiye — har guide ek hi cheez saaf karta hai.