Individuals who already have Niramaya Health Insurance and wish to inquire about their claim status, we will guide you through the Niramaya Health Insurance Claim Status process in a simple and easy-to-understand manner. Niramaya Health Insurance provides crucial financial support for medical treatments to persons with disabilities in India. After submitting a claim, it is natural to check the status of it.
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Niramaya Health Insurance
Niramaya Health Insurance provides coverage specifically designed for individuals with disabilities, offering affordable insurance plans. Managed entirely by the National Trust under the Ministry of Social Justice and Empowerment, Niramaya extends health coverage through health cards, providing benefits of up to 1 lakh per person.
In addition to these features, Niramaya Health Insurance offers other important benefits. In this article, we will explore the process of checking the Niramaya claim settlement & Status.
Required Documents for Nirayama Claim Settlement
- Niramaya Health Card or Health ID Number
- Claim Form (duly filled)
- Disability Certificate (attested copy)
- Original prescription papers given by the doctor
- All original bills of Hospital / Medicine / Doctor fee / Therapy fee / Conveyance etc.
- All reports in Original
- Complete bank details of Beneficiary: Account No. / Bank Name / Branch (City & State) / IFSC Code
Niramaya Health Insurance Claim Settlement Process
Niramaya Health Insurance that claim settlement should submit within 30 days of treatment or discharge from the hospital. The most important tip is to ensure that all details on the Niramaya card, bills, or reports are exactly the same, and a valid mobile number is linked to it. Kindly gather all the above mentioned documents, both originals and photocopies, as they will be useful for future reference.
- Submit Claim Within 30 Days: Ensure that the claim is submitted within 30 days of treatment or discharge from the hospital.
- Download Niramaya Claim Settlement Form: Download the claim settlement form from the official website and carefully fill it out. The information provided should match the details on both bills and the Niramaya card.
- Address or Report Changes: If there are any changes or updates in the address or reports, attach the proper supporting documents. Additionally, transportation charges bills can also be attached (in originals).
- Reimbursement Structure: Review the reimbursement structure provided in the claim settlement form for a clear understanding of the process.
- Fill Part-C EFT (Electronic Funds Transfer): Complete the bank details section (Part-C EFT) accurately, ensuring that your beneficiary bank details are entered correctly.
- Attach Documents: After filling out the claim form, attach all the aforementioned documents, including originals, and organize them in a file for submission to the third-party administrator.
- Third-Party Administrator: For Niramaya Insurance, Raksha TPA Pvt. Ltd. acts as the third-party administrator. Therefore, send the files to the regional centers of Raksha TPA Pvt. Ltd.
Raksha TPA Regional Office: Plot No-42, 1st Floor, Sector 20A, Victora Building,Next to Institute of Chartered Accountant of India ,Faridabad 121013, Haryana.
How to Check Niramaya Health Insurance Claim Status
After successfully submitting the claim forms, you will need to wait for a few days. Subsequently, you will receive all pertinent details via mobile and email. In the event that further information is required, the insurance provider will contact you.
To check the Niramaya Insurance claim status, follow these steps:
- Visit the provided link: Click Here
- The Raksha TPA claim status portal will open.
- Enter any of the specified numbers (Member ID, Claim Number, Employee Number, Policy Number) and click on the submit option.
- Your insurance claim details will then be visible on the screen.
- Under the status section, you can view the current status and corresponding steps.
Understanding Your Claim Status
The claim status update you receive might be one of the following:
- Submitted: Your claim form and documents have been received by Raksha TPA.
- Under Process: Your claim is being reviewed by the TPA and insurance company.
- Documents Required: Additional documents might be needed to process your claim.
- Approved: Your claim has been approved for reimbursement.
- Settled: The claim amount has been credited to your bank account.
- Rejected:Â Unfortunately, your claim has been rejected. The reason for rejection will be mentioned in the update.
Contact Details
Contact Details of Raksha TPA for Claim Details:
- Ms. Sushma: 7838151573
- Mr. Ashok Narwat:
- Contact Number: 7838151524
- Email: ashok.narwat@rakshatpa.com
- Mr. Mridual Singh:
- Contact Number: 8860612186
- Email: mridul.singh@rakshatpa.com
24-Hour Customer Care:
- Email: crcm@rakshatpa.com
- Faridabad: 0129-3501420, 1800-180-1444
- Mumbai: 022-67876666, 1800-220-456
- Bangalore: 080-42839999, 1800-425-8910
Special Assistance Number: 1800-180-1444
Raksha TPA Regional and Head Office Address: Plot No: 42, Victoria Building, First Floor, Sector 20A, Near ICAI Building, Faridabad – Haryana – 121013.
| Niramaya Official Portal | Click Here |
| Niramaya Claim Settlement Application Form | Click Here |
| Raksha TPA Claim Status Link | Click Here |
| For Our Website for More Updates | Click Here |