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  1. In case the Insurer / TPA is not liable to settle the hospital bill, I undertake to settle the bill as per the terms and. conditions of the policy. c . amounts over & above the limit authorized by the Insurer/T.P.A not governed by the terms and conditions of the policy will be paid by me.

  2. If clinical details provided are insufficient, Insurer/TPA may delay the authorization or denial for cashless access. 7. We confirm that no additional amount would be collected from the insured in excess of Agreed Package Rates except costs towards non-

  3. For Cashless : cashless@rakshatpa.com. For IT Related Grievances. 0129-2577039. E-mail : it@rakshatpa.com

  4. Non-network hospital should send the request for cashless to Raksha at least 48 hours prior to the date of admission for all elective procedures. Cashless requests for emergency treatments need to be shared within 48 hours of the admission.

  5. Main Claim - (Hospitalization Claim) This is reimbursements of your medical expenses incurred during hospital. admission. The admission should be for a planned medical treatment or a medical emergency. Pre Post - Expenses incurred for tests & diagnostics leading to treatment before 30 days and after 60 days of.

  6. REQUEST FOR CASHLESS HOSPITALISATION FOR MEDICAL INSURANCE POLICY DETAILS OF THE THIRD PARTY ADMINISTRATOR a) b) (To be filled in block letters) Name of TPA/ Insurance Company : Raksha TPA Pvt. Ltd] Toll free phone number . 1800 180 1444 , 0129 - 4289999 Toll free FAX: 0129 4289988 TO BE FILLED BY THE INSURED / PATIENT Name of the Patient: c) a) b)

  7. Cashless claims Cashless hospitalization can be availed only at a Medi Assist network hospital and upon approval of your pre-authorization application. Click here, for details of availing cashless hospitalization.