WE ASSIST is ONE of its Kind Services Designed to help Health Insurance Customers for a hassle-free Reimbursement Claim Experience
1) End to End
Solutions to all
types of insurance
Voice and non- Voice
with Insurer / TPA
Chairman – KICPL
The success and sustainability of every organization lie on its Founder and his/her values and foresight. KICPL has also the same story. Mr. Nair started insurance advisory in Bangalore in the year 1971. It was his hard work and conviction helped him to succeed and become one of the star performers of Life Insurance Corporation of India, Bangalore. His discipline and humility at work is commendable and it has laid a strong foundation for KICPL. He is currently mentoring the team behind KICPL and KI.
Chief Mentor & Financial Controller - KI
Managing Director - KICPL
A graduate with rich experience in the investment services spectrum, Insurance Advisory & Mutual Fund consulting. He possesses excellent communication and interpersonal skills and started his career as an insurance advisor. He founded KICPL in 2007 under the guidance of Mr. Nair and it has evolved into a full spectrum investment consulting services company provides service such as Life Insurance, General Insurance, Mutual Funds, Equity trading, Bonds, Government Securities and many more. He is a Chairman’s club member in Life Insurance Corporation of India and a member of prestigious Million Dollar Round Table (MDRT).
Principal Officer – Karthika Insurance
A post graduate from NIFT, New Delhi. He was awarded the Gold Medal from the President of India Dr. APJ Abdul Kalam for the Academic Excellence. He has over 12 years of experience working on events like Fashion Weeks, product launches, international exhibitions and in his last assignment was with TIC. At TIC he managed the T1 Truck Racing Event for the first time in India, which was awarded the Best Event of 2014 and 2015. He joined KICPL in 2014 and subsequently launched Karthika Insurance in 2015.
What is Reimbursement Claims?
It is a claim where the member pays all the expenses related to the hospitalization and submits the claim to the TPA/ Insurance for reimbursement of expenses.
“We Assist” Services:
Customers buy Health Insurance through Online, Agents, Brokers, Direct and Banks but they face lot of challenges right from submission of claim to TPA or Insurance companies till realization of their claimed amount.
Our Health Insurance Expert team thoroughly examined the challenges faced by the Insured customers and provides hassle free end to end Reimbursement claim assistance.
The Process for Reimbursement claims assistance as follows:
Cashless: It can be availed only at network hospitals of TPA’s/Insurance to the amount of pre-authorisation sanctioned.
Reimbursement: It is a claim where the member pays all the expenses related to the hospitalization and submits the claim to the TPA/Insurance for reimbursement of expenses.
The liability for paying the hospital will be on you. You would have to submit the claim documents to TPA’s/Insurance for reimbursement. The Insurance company will then reimburse the admissible amount to you.
Expenses incurred at a hospital or a nursing home for diagnostic purposes such as X-rays, blood analysis, ECG, etc. will be reimbursed if they are related to the ailment for which the policy-holder has been hospitalized. In any other scenario, these expenses will not be reimburse.
The claim amount is paid to the registered nominee of the insured.
Co-pay is the percentage applied on payable amount which the policy-holder has to bear.
Yes, claims will be reimbursed even if insured is not treated in a network hospital. The hospital should fall under the definition of Policy wordings.
There is no restriction on the size of the individual claim in a year as long as the family does not exceed the Sum Insured.
If your cashless is rejected due to some reason, please make the payment and submit the bills for reimbursement, claim will be reviewed as per policy terms & conditions.
There is no limit on the number of claims in a years, claim amount will be limited to Sum Insured.
Deductions can pertain to non medical expenses, non submission of bills, co pay deductions etc.,
This is a very important document; it will mention the Date of Admission and Date of Discharge, Past History, details of treatment given, and requirement of medication post hospitalization, if any and doctor’s signature. This will be on the letter head of the hospital.
There is no limit on the number of times one can take treatment, however insurance company will reimburse claims up to the sum insured. And subject to policy terms.