Emergency hospitalization at a network hospital:
In case of an emergency if an insured member goes to a network
hospital and after giving initial treatment, the treating doctor
decides to admit the insured member based on the severity of illness,
he/ she will be required to present his / her original health card at the admission office.
The hospital will check the validity of the health card. The hospital will
itself notify EFU Life Ltd of the hospitalization.
Approval will be given as per policy terms and conditions.
Once the insured will be discharged it will be the hospital’s responsibility
to send the original bills along with all supportive documents and a copy
of the approved Pre authorization / Approval form to EFU Life
Ltd and payment would be made directly to the hospital.
Planned hospitalization at a network hospital:
If an insured is advised admission and plans to get hospitalized
at a network hospital then he /she will send a completely filled
Pre Authorization form to EFU Life Ltd two working
days prior to the admission for approval.
Completely filled Pre-authorization forms can be
submitted at the corporate office of the network
hospital and hospital can send the form to EFU Life for
approval or the insured member can send the Pre-authorization form to
EFU Life directly also. Approval will be given if the treatment is
covered as per the policy terms and condition.
Once approval is given the insured will get hospitalized at the network
hospital, take treatment and get discharged. The hospital itself will send
the original bills along with all supportive documents and a copy of the
approved Pre authorization form to EFU Life.
Payment would be made directly to the hospital.