TCS India - Health Insurance Scheme (HIS) - Claim Guidelines
Accessing Medi Assist Portal
You may access the Insurance portal by logging in to: Ultimatix
-> Employee Services -> Health & Wellness -> Medi
Assist. Note: Link should be opened using only Internet Explorer
(IE) 8.0 and above or Google Chrome and ensure the cookies,
browsing history and Cache is deleted. If you have forgotten your
Ultimatix Password then please contact the Global Helpdesk or
Email: [email protected] Phone: 60605555/022-25188155 Buzz
(VoIP): 500 5555
Important guidelines for processing of HIS Claims
Staple and number the Claim Form along with supporting documents
(in case of multiple claims, staple them separately and mention the
number of documents).
Raise separate Claim requests for each illness.
Write your employee ID and HIS Claim category either Domiciliary
and/ or Hospitalisation and mention the total number of claims on
the envelope containing the documents. Ensure each supporting
document has employee ID and Claim number written on it.
Retain the scanned or photo copies of all the documents to
produce them if/ when required.
Submit the original documents along with the duly filled Claim
Form in the drop-box at TCS office location (Refer Contact
Matrix).
Submit the Claim documents within 7 days from the Claim Request
Generation date; else the Claim request will be rejected.
Hospitalization Claim Hospitalisation benefits are applicable
only if the insured person is admitted to a hospital continuously
for a minimum of 24 hours (with exception to Day Care Procedures
mentioned in the policy).
Following are the mandatory documents for processing the
Hospitalisation Claims:
Duly filled and signed Claim Form as generated through the Medi
Assist portal.
Original and detailed admission or discharge summary/card issued
by the hospital with details line of treatment
Detailed hospital bills along with break-up bill of all
hospitalisation expenses
Original and pre numbered bill/receipt/cash memo issued by the
hospital
Copies of all investigations, lab or test reports (wherever
applicable) from hospitals or from any other lab or diagnostic
centres during and before or after the hospitalisation.
Original medical bills or receipts with prescriptions for the
medicines purchased from the pharmacy store
Copy of FIR/ MLC in case of accidental claim
mailto:[email protected]
Domiciliary and Domiciliary Dental Claim Domiciliary treatment
covers all illnesses (subject to policy conditions) that do not
require hospitalisation including treatments taken either from a
physician or at the OPD in a hospital.
Domiciliary Dental claim will only cover expenses towards
extraction, fillings, medicines, consultants fees, and X-rays.
Following are the mandatory documents required for processing
the Domiciliary/Dental Claims:
Duly filled and signed Claim Form as generated through the
portal.
Doctors prescription with details of the nature and duration of
illness. (Ailment should be mentioned on the prescription)No
payment details should be mentioned in this document
Original pre-numbered bills from the doctors official receipt
book, with pre-printed doctors information and receipt number.
Blank document with the doctors signature and stamp will not be
considered as a receipt proof Note: Doctors prescriptions/ letter
head bills will not be accepted by the insurance company
Original medical bills or receipt along with prescriptions for
the medicines purchased from the pharmacy stores Note: The bills or
receipts produced should be within the policy period
Copies of all investigations/ labs/ test reports (wherever
applicable) from hospitals or from other lab or diagnostic centres
during and before or after the hospitalisation Note: Prescription
for the particular financial year only will be considered as
valid
Dental Treatment: Day-to-day case summary (day-wise treatment
undergone during the entire cycle of the treatment) in case of Root
Canal or other dental treatment where multiple visits or sittings
are being carried out
Dental Treatment: X-ray film or X Ray reports
