Claims support
A claim usually arrives on a difficult day. Whatever the policy - health, life, home or cyber - a dedicated MITRA claim expert carries the process so you can be where you're needed.
Start here
In a cashless claim, the insurer settles directly with a network hospital or provider - you never handle the main bill. In a reimbursement claim, you pay first, anywhere you choose, and the insurer repays you after reviewing your documents. Neither route is better - cashless is easier on your wallet, reimbursement gives you full freedom of choice. What decides how smoothly either goes is the quality of the file and the follow-up. That's the part MITRA owns.
Words you'll hear
What happens when
The same five stages, whatever the product. At every one, here's exactly what's yours to do - and what's ours.
Tell us what happened - that's all.
We confirm your coverage, intimate the insurer within the deadline, and share the exact document list for your situation.
Share documents as you receive them - photos of bills and reports are fine.
We pre-fill every form, verify each document against the insurer's requirements, and flag gaps before anything is submitted.
Nothing. Really.
We submit a complete file and confirm receipt with the insurer or TPA - so the clock officially starts.
Stay informed, not involved. We update you at every movement.
We answer insurer queries, chase follow-ups, and escalate delays - pushing back when queries turn repetitive.
Receive your cashless discharge or payout to your bank account.
We reconcile the settlement line by line, explain every deduction in plain words - and contest anything unsupported.
You can watch it happen. Every claim your expert handles shows up live in the MITRA app - intimation, pre-authorisation, the insurer's queries, settlement - updated as it moves, with your named expert one tap away. The app doesn't replace the human doing the work; it just lets you see the work, without calling to ask where things stand. It's included free the moment you're a customer.
Claim process by product
Pick your policy type for its step-by-step claim process, documents and timelines.
Your claim expert
Not a call centre that starts from zero each time. Not a chatbot. A trained claims professional who knows your policy and owns the process from intimation to settlement.
Pre-fills forms, verifies every document against your insurer's requirements, and flags gaps before submission - the strongest way to prevent avoidable delays.
Hospital desk, TPA, surveyor or insurer - we make the follow-up calls so you do not have to chase each participant.
If something admissible is denied, we contest it with policy wording, documentation and escalation to the insurer's grievance cell where valid grounds exist.
Be claim-ready
These apply to almost every claim, whatever the product. Product-specific documents are listed on each product's claim process - and your expert confirms the exact list before anything is submitted.
The hard truth, handled
Most rejections are not about bad luck. They are procedural - and many are preventable, either on the day you buy or on the day you file.
Hidden health conditions, smoking or occupation details can create serious disputes. We check the application before purchase so the record is accurate.
Every policy sets reporting expectations. Your expert records and routes the intimation as soon as you reach us.
Missing reports or inconsistent details trigger queries and delays. Every file is verified page by page before submission.
A condition inside an active waiting period may not be payable. Waiting periods are explained at purchase and checked before filing.
Excluded treatment, unlicensed driving or undeclared use can invalidate a claim. Relevant limits are explained before purchase and checked before filing.
Already rejected?
We first read the decision against the actual policy wording and tell you honestly whether there are grounds. When there are, we build the written case in stages.
We compare the stated reason with the policy, proposal and evidence - and say plainly when no valid grounds exist.
Where grounds exist, we correct the file or escalate to the insurer's grievance cell with a documented, wording-based case.
If the grievance route fails, we help prepare the available Ombudsman route, subject to its jurisdiction and limits.
Claims questions
Handle safety and treatment first. Then contact your claim expert. We will confirm coverage, explain what to preserve and start the appropriate process.
It depends on the route and product. Cashless requests move on the insurer or TPA's turnaround; reimbursement claims move after a complete file is submitted. A complete, coherent file prevents avoidable rounds of queries.
Yes. End-to-end claims assistance is included with every eligible policy bought through MITRA, for the life of the policy including renewals. MITRA does not take a cut of the settlement.
Queries are normal, but they should be answered once and completely. Your expert responds with verified documents and pushes back in writing when requests become repetitive or unreasonable.
A Third-Party Administrator processes health claims on an insurer's behalf. Loop in your claim expert so the request can be understood, documented and answered accurately.
Often, yes. We review the decision against the policy and evidence. Where valid grounds exist, we help re-file or use the insurer's grievance process and other available forums.
The full claims promise applies to policies bought or ported through MITRA. For another policy, we can still explain the likely next route, but cannot promise the same end-to-end service.
It depends on the product. A claim may consume the available limit or affect accumulated benefits. Your expert explains the consequences before filing whenever the decision is still yours to make.
Yes. Every claim your MITRA expert handles shows up live in the MITRA app - intimation, pre-authorisation, the insurer's queries and settlement, updated as it moves, with your expert one tap away. You get the app free once you're a customer. The phone line at 9021 323 456 works exactly as before - the app simply lets you watch the claim without calling to ask where it stands.
No - and this matters to us. The claims support is the human expert; the app just makes their work visible. You can run your entire claim by phone, exactly as before. The app comes free with your policy if you'd like to see each step and reach your expert faster - it's never a hoop you have to jump through.
Free · Unbiased · No pressure
Request a callback and a claim expert will help you understand the next step.
