Reimbursement
Points to Remember
  • Assistance service provider is to be intimated in the event of any treatment, non intimation may invalidate the claim.
  • Cashless will be extended for all in-patient treatments only when service provider is intimated & pre approval obtained (as per policy T & C)
  • OPD Claims & claims other then In-Patient will be reimbursed upon return to India.
  • Policy does not cover traveling abroad for obtaining medical treatment & travelling against medical advice.

The claim file has to be submitted at the below mentioned addresses within 30 days from after the date of loss.

Courier Address
Strive Insurance Brokers pvt. ltd.
Personal Accident
  • Copy of FIR (filed with the local police authorities)
  • Claim Form (to be filled and signed by insured)
  • Release of Medical Information Form (ROMIF) BAJAJ and AGA (to be filled and signed by insured) to obtain the medical records from facility
  • Medical records/Consultation Papers/Investigation Reports in case any hospitalization
  • Death certificate/Post Mortem report in case its conducted (In case of Death)
  • Certificate from Civil surgeon certifying the extent and percentage of disability (For Disability claims)
  • NEFT form and Cancelled cheque stating insured's (nominee in case of death claim) Claimant Indian Bank account details
  • Passport and Visa copy with Entry Stamp Overseas and exit Stamp from India
Personal Accident
  • Claim Form (to be filled and signed by insured)
  • Attending Physician Statement (to be filled and signed by overseas treating doctor)
  • Release of Medical Information Form (ROMIF) BAJAJ and AGA (to be filled and signed by insured) to obtain the medical records from facility
  • Medical records/Consultation Papers/Investigation Reports
  • Invoices / Bills towards medical expenses.
  • NEFT Form and Cancelled cheque stating insured’s / Claimant Indian Bank account details (for reimbursement claim).
  • Passport and Visa copy with Entry Stamp Overseas and exit Stamp from India.
  • Deductible amount as per policy schedule to be issued with DD/ Cheque in favour of Bajaj Allianz General Insurance Company Ltd (in case of complete cashless subject to confirmation of admissibility from “Us”. In case inability to provide deductible amount from insured same can be deducted from your cashless bill.
Medical Evalution
  • Claim Form (to be filled and signed by insured)
  • Attending Physician Statement (to be filled and signed by overseas treating doctor)
  • Release of Medical Information Form (ROMIF) BAJAJ and AGA (to be filled and signed by insured) to obtain the medical records from facility
  • Medical records/Consultation Papers/Investigation Reports
  • Invoices / Bills towards medical expenses.
  • Original Paid receipts (hardcopy) in case of reimbursement claim.
  • Form and Cancelled cheque stating insured’s / Claimant Indian Bank account details (for reimbursement claim).
  • Passport and Visa copy with Entry Stamp Overseas and exit Stamp from India.
  • Deductible amount as per policy schedule to be issued with DD/ Cheque in favour of Bajaj Allianz General Insurance Company Ltd (in case of complete cashless subject to confirmation of admissibility from “Us”. In case inability to provide deductible amount from insured same can be deducted from your cashless bill.
Repartiration
  • Claim Form (to be filled and signed by assignee)
  • Invoices / Bills towards medical expenses
  • Original Paid receipts (hardcopy) in case of reimbursement claim
  • Death certificate/Post Mortem report/ Certificate of emblem in case its conducted
  • NEFT Form and Cancelled cheque stating assignee‘s Indian Bank account details (for reimbursement claim.)
  • Cancelled passport and Visa copy

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