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Health Insurance Claim Checklist

Complete documentation guide for hassle-free claim processing

PDF Documents Required Hospital Paperwork Medical Reports
Last Updated
05 Aug 2026

Maternity Case

12 Items
  • 1Claim Form
  • 2Cancellation Cheque
  • 3Patient Identity Proof (Xerox Copy)
  • 4Health Card (Xerox Copy)
  • 5Investigation Report (Original)
  • 6Doctor Prescription (Original)
  • 7Medicine Bill with Breakup
  • 8Final Bill on Hospital Letter Head with Money Receipt
  • 9Discharge Summary on Hospital Letter Head
  • 10GPLA Certificate
  • 11Ultra Sound Report (Last Month)
  • 12Claim Form Part B (Hospital Filled - IRDA Required)

Accident Case

14 Items
  • 1Claim Form
  • 2Cancellation Cheque
  • 3Patient Identity Proof (Xerox Copy)
  • 4Health Card (Xerox Copy)
  • 5Investigation Report (Original)
  • 6Doctor Prescription (Original)
  • 7Medicine Bill with Breakup
  • 8Final Bill on Hospital Letter Head with Money Receipt
  • 9Discharge Summary on Hospital Letter Head
  • 10MLC (Medical Legal Certificate)
  • 11Doctor Certificate (If Patient was Alcoholic)
  • 12ICP (Indoor Case Paper)
  • 13Police Verification Report / FIR Copy
  • 14Claim Form Part B (Hospital Filled - IRDA Required)

General Admission

11 Items
  • 1Claim Form
  • 2Cancellation Cheque
  • 3Patient Identity Proof (Xerox Copy)
  • 4Health Card (Xerox Copy)
  • 5Investigation Report (Original)
  • 6Doctor Prescription (Original)
  • 7Medicine Bill with Breakup
  • 8Final Bill on Hospital Letter Head with Money Receipt
  • 9Discharge Summary on Hospital Letter Head
  • 10ICP (Indoor Case Paper)
  • 11Claim Form Part B (Hospital Filled - IRDA Required)

Cataract Operation

13 Items
  • 1Claim Form
  • 2Cancellation Cheque
  • 3Patient Identity Proof (Xerox Copy)
  • 4Health Card (Xerox Copy)
  • 5Investigation Report (Original)
  • 6Doctor Prescription (Original)
  • 7Medicine Bill with Breakup
  • 8Final Bill with Proper Money Receipt
  • 9Discharge Summary
  • 10IOL Card
  • 11Biometric Report
  • 12Tax Invoice of Lens
  • 13Claim Form Part B (Hospital Filled - IRDA Required)

💳 Cashless Transactions For Employees

If an employee opts for cashless treatment, the following documents must be submitted to the TPA at the selected hospital

Health ID Card

Mandatory Document

  • Original Health Card issued by the insurance company
  • Must be valid and active at the time of admission
  • Contains Unique Health ID and policy details
  • Xerox copy to be submitted to TPA along with original for verification

Identity Proof (Aadhar Card)

Government Approved ID Proof

  • Aadhar Card is the primary identity proof required
  • Self-attested Xerox copy to be submitted
  • Must match the name on the Health Card
  • Other valid IDs: PAN Card, Voter ID, Passport (if Aadhar not available)

Selected Hospital

Choose a Network Hospital

  • Hospital must be in the TPA Network
  • Inform the hospital about cashless facility at the time of admission
  • Hospital will coordinate with TPA for cashless approval
  • Keep a copy of the Pre-Authorization Form for reference

TPA Document Submission

Documents to be submitted to TPA

  • Health Card (Original + Xerox)
  • Aadhar Card (Self-attested Xerox)
  • Pre-Authorization Form filled by the hospital
  • TPA will process and approve the cashless request
  • Approval takes 2-4 hours in normal cases

Step-by-Step Process for Cashless Transactions

1
Visit Network Hospital

Go to a TPA-empaneled hospital for treatment

2
Submit Documents

Provide Health ID Card and Aadhar Card copies

3
Fill Pre-Authorization

Hospital fills and submits the pre-authorization form to TPA

4
TPA Approval

TPA verifies documents and approves cashless treatment

5
Treatment & Discharge

Receive treatment, hospital settles bill with TPA directly

⚠️ Important Note for Employees

Both Health ID Card and Aadhar Card are mandatory for cashless transactions. Ensure that the documents are valid and the name on both documents matches exactly. In case of any discrepancy, please contact the TPA or HR department immediately.

Cashless approval is subject to TPA verification and policy terms.

📋 Claim Form Part B

This form must be filled by the hospital as per IRDA Guidelines. It is mandatory for all claim submissions.

IRDA Mandatory Document - Required for all claim types
Download Claim Form Part B (PDF)

Secure & Instant Download

📞 Escalation Matrix For IR Query & Pending Documents

Contact the appropriate level for assistance with IR queries and pending document issues

Level 1 - Primary Contact
MR RUPAM BHATTARCHERJEE
9401591703
rupam.bhattarjee@fhpl.net
Recommended first point of contact
Level 2 - Escalation
MR PANKAJ BANIK
9435888477
pankaj.banik@fhpl.net
Escalate if Level 1 is unavailable
Level 3 - Senior Escalation
BISWAJIT CHANDRA DAS
9864108389
biswajit.das@fhpl.net
Escalate if Level 2 is unavailable
Level 4 - Final Escalation
ARNAB ROY
6292263994
arnab.roy@fhpl.net
Final escalation point

💡 Recommended Action

For any IR query or pending document issues, we recommend you to first contact Level 1 - MR RUPAM BHATTARCHERJEE at 9401591703 or via email at rupam.bhattarjee@fhpl.net.

If your query is not resolved within 24-48 hours, please escalate to the next level.

Guwahati Office Head Office

FAMILY HEALTH PLAN INSURANCE TPA LIMITED
H/NO 6, 2ND FLOOR, NARENDRA COMPLEX, S.S.ROAD LAKHOTIKA,
NEAR PANBAZAR FLY OVER, GUWAHATI - 781001

0361-2632214 / 0361-2632217

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