The insurance company will insist upon a succession certificate from court of law for disbursing the claim amount. In the alternative the insures can deposit the claim amount in the court for disbursement to next legal heirs of the deceased

One can become the member of this TPA by taking an individual Policy/Group policy from any of the RO’s that we service.

Apart from the other value added services, by becoming a member of TPA, one has an access to a large number of healthcare providers all over the country for “Cashless Treatment”.

Cashless treatment provides the members the comfort of taking treatment in network hospitals without paying a single rupee subject to terms of the pre-authorisation being approved. The member need not worry about claim settlement as the provider bills the TPA directly.

Once you have the premium, submitted the photos, and received a copy of the policy papers, the same is submitted to the TPA by the insurance Co. An ID card is then generated and is dispatched to the member to the address mentioned on the policy paper.

The ID card can be used across the network hospitals to obtain cashless treatment. The insurance details are present on the ID card and the hospital uses the same to send the pre- authorisation.

To avail cashless treatment, in case of elective visits, the member needs to approach the network hospital about 2 days before the likely date of admission along-with the ID card of the patient and flash the same at the hospital. Then request the hospital to send across the pre-auth fax to Safeway for approval of cashless treatment. For emergency cases, admission can be done and the fax can be sent within 24 hours. However, it is must that the Safeway ID card be present with the member always.

Pre-authorisation is the prior approval that is required to be taken from Safeway to grant cashless treatment in a network hospital.

Safeway enters the data as per the information what is given on the policy paper. If the policy paper contains the name/address incorrectly then, an endorsement from the Insurance Company is required in order to make the changes.

Yes, the list can be sent across through the e-mail or the hard copy can be given, if one visits Safeway in person.

This information is given on phone if anyone calls the toll free number.

The intimation needs to contain details like policy number UHID#, name of the hospital, date of the admission and the medical condition of the patient. This information can be faxed or sent by post to TPA.

The claim form can be obtained in any office of the Insurance Company or with the TPA.

Appropriate status is given according to the stage under which the claim is in viz; under process; pending for information from member/insurance; processing completed and readt for dispatch or rejected.

In such a case the hospital needs to mention the same on its leeterhead along-with the seal and signatures of the treating doctor and the medical administrator. Attested photocopies are also accepted by the TPA in such a case bearing the seal and the signatures of the treating doctor and the medical administrator.

No, this is not allowed as per the guidelines from the Insurance Company. An endorsement is required from the insurance stating the same.

Yes, this can be done by producing the required documents to Safeway.

The cheque will be dispatched as sonn as possible (we do not have an answer in such a case as, we are not supposed to reveal the insufficiency of float funds received and also, we have no answer for the payment of interest charges).

The insurance company is supposed to send a reply within 15 days from the date of rejection intimation letter.

Safeway waits for response from insurance Co. for 15 days from the date of rejection intimation letter. If no reply is received, then Safeway takes a decision on rejection and intimates the member accordingly.

The member can be appeal to the TPA Cell appointed by Insurance companies at their Respective Regional Offices.

Yes. The claim can be returned and considered as no claim

Assurance of Qualitative Healthcare delivery
* No necessity to pay any advance at the time of admission nor to settle bills at the time of discharge.
* Comfort extended to the patient/employee/family at the time of crisis due to medical emergency.
* Additional comfort that second opinion is always at hand, where necessary.

Emphasis is on qualitative healthcare delivery to the members of the Safeway. The range of facilities at the provider are analysed at various levels of healthcare viz. Primary, Secondary and Teriary. Medical capabilities w.r.t. emergencies and trauma conditions are evaluated. Bed strength, Medical Equipments, Eminent consultants, Skilled medical professionals. Intensive Care facilities, Ambulance, Lab facilities, Technicians, Geographical spread, Population coverage, Chain of hospitals, Tariff, Medical performance, etc., are the other factors that determine the inclusion of a healthcare provider into the Safeway Network.