If you wish to make a claim please select the type of policy you hold and then choose the appropriate claims form. If you are unsure, please refer to your policy wording booklet which will have been issued to you when you purchased your insurance or view here.

Cashless Claims Procedure:

Applicable only for Accidental Hospitalization Expenses Optional Cover Cashless treatment is only available at Network Hospitals. In order to avail of cashless treatment, the following procedure must be followed by You:
a. Prior to taking treatment and/or incurring Medical Expenses for any Accidental Injury, at a Network Hospital, the Insured Person must call Us and request pre-authorization by way of the written form which the Company will provide. Waiver of this condition shall be considered in case of emergency hospitalisation arising out of accidental bodily injury.
b. After considering the Insured’s request and after obtaining any further information or documentation the Company have sought, the Company may if satisfied send to the Insured Person or the Network Hospital, an authorization letter. The authorization letter, the ID card issued to the Insured along with this Policy and any other information or documentation that the Company have specified must be produced to the Network Hospital identified in the pre-authorization letter at the time of Insured’s admission to the same.
c. If the procedure above is followed, the Insured Person will not be required to directly pay for the Medical Expenses raised out of Accidental Bodily Injury, in the Network Hospital that the Company is liable to indemnify under Accidental Hospitalization Expenses Section and the original bills and evidence of treatment in respect of the same shall be left with the Network Hospital. Pre-authorization does not guarantee that all costs and expenses will be covered. We reserve the right to review each claim for Medical Expenses and accordingly coverage will be determined according to the terms and conditions of this Policy. Insured Person shall, in any event, be required to settle all other expenses directly.

List of Claims Document (Specific to Accidental Hospitalisation Expenses Optional cover)

Duly completed pre authorization signed by the Claimant

Other documents as may be required by the Company to process the claim

Reimbursement Claim Procedure of All Sections

If you meet with any Accidental Bodily Injury that may result in a claim, then as a condition precedent to our liability:

  1. You or someone claiming on your behalf must inform us in writing immediately and in any event within 30 days from the date of the accident and submit all documents to us within 30 days from the date of intimation.
  2. You must immediately consult a Doctor and follow the advice and treatment that he recommends.
  3. You must take reasonable steps to lessen the consequence of Bodily injury.
  4. You should allow examination by our medical advisors if we ask for this.
  5. You or someone claiming on your behalf must promptly give us documentation and other information we ask for to investigate the claim or our obligation to make payment for it.
  6. In case of your death, someone claiming on your behalf must inform us in writing immediately and send us a copy of the post mortem report (if conducted) within 30 days.
*Note: Waiver of conditions (a) and (f) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which the Insured Person was placed, it was not possible for the Insured Person or any other person claiming on his/her behalf to give notice or file claim within the prescribed time limit.
Please refer to the detailed list of documents required as per the sections opted

List of Claim documents for Death

Duly Completed Claim Form signed by Nominee/ legal heir of the Insured Person.

  • Copy of address proof (Ration card or electricity bill copy).
  • Attested copy of Death Certificate.
  • Burial Certificate (wherever applicable).
  • Attested copy of Statement of Witness, if any lodged with
  • police authorities.
  • Attested copy of FIR / Panchanama / Inquest Panchanama.
  • Attested copy of Post Mortem Report (only if conducted).
  • Attested copy of Viscera report if any (Only if Post Mortem is conducted).
  • NEFT details & cancelled cheque of the Nominee/ legal heir of the insured Perso
  • Original Policy copy along with Original Assignment endorsement (if any)

Document Specific to Air Ambulance Cover

  • Duly completed claim form signed by the Claimant
  • Original bills and receipts paid for the transportation from Registered Ambulance Service Provider
  • Other documents as may be required by the Company to process the claim

List of Claim Document Specific to Children Education Benefit

Bonafide certificate from school / college or certificate from the educational institution

List of Claim Document Specific to Fracture Care Cover

  • X Ray confirming the fracture & site of fracture
  • Certificate from treating surgeon with extent of Injury, cause of injury, site of Injury & date of injury
  • Treatment details
  • Discharge summary (if Hospitalized )
  • Letter from HR of leave record in case of salaried individual

List of Claim Documents Specific to Hospital Cash Benefit Cover

  • First Consultation letter from the Doctor
  • Duly completed claim form signed by the Claimant
  • Hospital Discharge Card
  • Hospital Bill Money Receipt, duly signed with a Revenue Stamp
  • All Laboratory and Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram, etc.
  • Other documents as may be required by the Company to process the claim.

List of Claim Documents Specific to Loss of Income due to Disability from Accident Cover

  • Duly Completed Personal Accident Claim Form signed by insured.
  • Attested copy of FIR. (If required)
  • All X-Ray / Investigation reports and films supporting to disability.
  • Claim form with NEFT details & cancelled cheque duly signed by Insured
  • Attested Policy copy.
  • For Employed persons: Certificate from HR with details of medical leave availed during the period of Injury
  • Certificate from the treating doctor mentioning the extent of Injury along with the period of disability
  • Certificate from Treating doctor with date of full recovery & resuming of duties

List of Claim Document Specific to Travel Expenses Benefit Cover

  • Original travel tickets / bills and receipts mentioning the actual expenses of the travel with the date of booking & date of travel
  • First Consultation letter from the Doctor
  • Duly completed claim form signed by the Claimant

List of Claim documents for Disappearance

Duly Completed Claim Form signed by Nominee/ legal heir of the Insured Person.

  • Copy of address proof (Ration card or electricity bill copy).
  • Attested copy confirming disappearance from appropriate authorityfollowing a forced landing, stranding, sinking or wrecking of a conveyance
  • Documentary proof of fare paying passenger of a conveyance as an occupant
  • Attested copy of Statement of Witness, if any lodged with police authorities.
  • Attested copy of FIR / Panchanama / Inquest Panchanama.
  • NEFT details & cancelled cheque of the Nominee/ legal heir of the insuredPerson
  • Original Policy copy along with Original Assignment endorsement (if any)Assignment endorsement (if any)

List of Claim documents for Permanent Total Disability and Permanent Partial Disability

  • Duly Completed Claim Form signed by Insured Person.
  • Attested copy of disability certificate from Civil Surgeon of Government Hospital stating percentage of disability.
  • Attested copy of FIR. (If required)
  • All X-Ray / Investigation reports and films supporting to disability.
  • Attested copy of FIR / Panchanama / Inquest Panchanama.
  • NEFT details & cancelled cheque of Insured Person.
  • Original Policy copy along with Original Assignment endorsement (if any)

List of Claim Document Specific to Adventure Sports Benefit

  • Certificate of participation from Sports event organizer/service provider
  • pre participation fitness certificate, and
  • certificate from the treating doctor mentioning the nature of the Injury,
  • All Investigation reports
  • Discharge summary ( If hospitalized)
  • Documents as listed for claim under Death / Permanent Total Disability

List of Claim Document Specific to EMI Payment Cover

  • Current outstanding Loan certificate from financer, along with the documents submitted
  • Loan disbursement letter along with the payment record till the date of Accident
  • All X-Ray / Investigation reports and films supporting to disability.
  • Claim form with NEFT details & cancelled cheque duly signed by Insured
  • Attested Policy copy.
  • For Employed persons: Certificate from HR with details of medical leave availed during the period of Injury
  • Certificate from the treating doctor mentioning the extent of Injury along with the period of disability
  • Certificate from treating doctor with date of full recovery & resuming of duties

List of Claim Document Specific to Loan Protector Cover

  • Loan disbursement letter along with the payment record till the date of Accident.
  • Current outstanding Loan certificate from financer, along with the documents
  • submitted for claim under Death or Permanent Total Disability.
  • Attested copy of Death Certificate.
  • All X-Ray / Investigation reports and films supporting to disability.
  • Claim form with NEFT details & cancelled cheque duly signed by Insured or his/her Nominee in case of Insured’s Death
  • Original Policy copy along with Original Assignment endorsement (if any)

List of Claim Document Specific to Road Ambulance Cover

  • First Consultation letter from the Doctor
  • Duly completed claim form signed by the Claimant
  • Original bills and receipts paid for the transportation from Registered Ambulance Service Provider
  • Treating Doctor certificate to transfer the Injured person to a higher medical centre for further treatment
  • All original Laboratory and Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.
  • Other documents as may be required by the Company to process the claim.

List of Claim Documents Specific for Accidental Hospitalization Expenses

  • First Consultation letter from the Doctor
  • Duly completed claim form signed by the Claimant
  • Hospital Discharge Card
  • Hospital Bill giving detailed break up of all expense heads mentioned in the bill. Clear break ups have to be mentioned for OT Charges,Doctor’s Consultation and Visit Charges, OT Consumables, Transfusions, Room Rent, etc.
  • All original Laboratory and Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.
  • Other documents as may be required by the Company to process the claim
All documents related to claims should be submitted to:

Health Administration Team
Bajaj Allianz General Insurance Co. Ltd
2nd Floor, Bajaj Finserv Building
Viman Nagar, Pune 411014
Toll Free no: 1800 209 5858
Note: If the original documents are submitted with the other insurer, the Xerox copies attested by the other insurer should be submitted

download the form related to the claim that must be submitted

FORM 1        

FORM 2        

In case of any doubts or confusions please read the policy wordings pdf here or write to us info@asc360.com

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