How to File a Health Insurance Claim Online in India

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Filing a health insurance reimbursement claim in India has become significantly easier in 2026 with digitisation — most major insurers now allow fully digital claim submission via app or portal. Yet claim rejection rates remain high, largely because policyholders don't know what documents to gather at the hospital or miss the intimation deadlines.

This step-by-step guide covers everything you need to file a clean, successful health insurance claim online in India.

When Do You Need to File a Reimbursement Claim?

Reimbursement claims apply when:

• You were hospitalised at a non-network hospital (cashless is not available)
• Cashless was denied at a network hospital and you paid upfront
• You needed emergency treatment and there was no network hospital available
• You're claiming for pre/post hospitalisation expenses (OPD, diagnostics, medicines before and after hospitalisation)

Cashless hospitalisation at network hospitals does not require a separate reimbursement claim — the hospital handles the settlement directly with the insurer.

Step 1: Intimate the Insurer Within the Required Timeframe

This is the step most policyholders miss, especially during a hospital emergency. IRDAI requires policyholders to intimate their insurer about hospitalisation within specific timeframes:

Type of Hospitalisation	Intimation Timeframe (Typical)
Planned (elective) admission	48–72 hours before admission
Emergency admission	Within 24 hours of admission
Post-hospitalisation claim (medicines, follow-ups)	Within 30–60 days of discharge
Full reimbursement claim submission	Within 15–30 days of discharge (varies by insurer)

Call your insurer's toll-free helpline or intimate via their app. Note the intimation reference number — you'll need it for all future correspondence on this claim.

Step 2: Gather All Documents at the Hospital

Before leaving the hospital, collect all of the following. Getting these documents after discharge is difficult:

Mandatory Documents

• Discharge summary: Detailed medical document summarising diagnosis, treatment, procedures performed, and discharge instructions. Get the original and ask for 2 signed copies.
• Final itemised bill: Each line item — room, nursing, medicines, procedures, surgeon fees, diagnostics. Reject a consolidated bill — ask for itemised.
• Original receipts for all payments made
• Investigation reports: All blood tests, ECG, X-ray, MRI, CT scan, pathology reports from before, during, and after hospitalisation
• Doctor's consultation notes / indoor case papers
• Pharmacy bills (during hospitalisation)

For Post-hospitalisation Claims (30–90 days after discharge)

• Follow-up consultation bills and prescriptions
• Medicine bills with prescription
• Diagnostic test reports and bills related to the discharge condition
• Physiotherapy or rehabilitation bills (if prescribed)

Step 3: Fill the Online Claim Form

Login to your insurer's portal or app. Most major insurers — Star Health (Star Health app), HDFC ERGO (HDFC ERGO app), Niva Bupa (Niva Bupa app), Care Health (Care Health app), ICICI Lombard (IL Take Care app) — have digital claim submission.

The online claim form typically asks for:

• Policy number and member details
• Hospital name, admission date, discharge date
• Primary diagnosis and treatment
• Total claim amount
• Bank account details for reimbursement (ensure the account matches the policyholder's name)
• Upload of all supporting documents (scan quality matters — clear, legible, full page)

Step 4: Submit and Track

After submission, you'll receive a claim reference number and a likely processing timeline (typically 15–30 days for complete claims). Under IRDAI regulations, insurers must settle or reject claims within 30 days of receiving all required documents. If additional documents are requested (a common tactic to reset the clock), respond within the stipulated period — typically 15 days.

Common Reasons for Claim Rejection or Deduction

Issue	Prevention
Incomplete discharge summary	Check discharge summary has diagnosis code, procedures, duration of illness
Blurry/incomplete document scans	Use a document scanner app (CamScanner, Adobe Scan) — not photos
Bills not in patient's name	Ensure hospital bills are in the insured person's name, not guardian's
Room rent exceeds policy limit	Check room rent limit before admission; proportionate deductions apply
Pre-existing condition linkage	If PED waiting period not served, PED-related claims won't be covered
Delay in intimation	Intimate within 24 hours of emergency admission; earlier for planned
Excluded procedures (cosmetic, dental, optical)	Know your exclusions before admission

Pre and Post Hospitalisation Claims

Most comprehensive health policies cover pre-hospitalisation expenses (30–60 days before admission) and post-hospitalisation expenses (60–90 days after discharge) for the same diagnosis. These include:

• Doctor consultation fees related to the hospitalised condition
• Diagnostic tests that led to hospitalisation
• Medicines prescribed in relation to the admitted condition

These are often not claimed because policyholders don't know they're eligible. Typically 10–15% of the hospitalisation claim amount can be recovered through pre/post claims — worth submitting. For planned hospitalisations using the cashless facility, read our guide on how cashless hospitalisation works in India — it explains the pre-authorisation process so you file clean claims from the start. If your claim gets rejected rather than partially deducted, our guide on what to do when an insurance claim is rejected in India covers the escalation steps that apply to health claims too. Also review the common health insurance exclusions before submitting your claim — knowing what's excluded helps you frame the right claim documentation.