Claim Settlement

Date: 21-Nov-2023
Dear Deepa .
We are always there for you in tough times!
We are pleased to inform you that your health claim number 202301761696 has been settled for INR
48163/-

Details of beneficiary
MPH Name/Proposer
MPH Number D098813624 STRIDES PHARMA SCIENCE LIMITED
name
Policy Number D098815889 Member ID N075435270506016
Insured/Patient
Deepa . Hospital Name St.Joseph Hospital
Name
DOA 2023-11-02 DOD 2023-11-06
Primary Primi with Oligohydraminose CPD with
Procedure NA
Diagnosis failded induction with MSL

Break-Up of the settlement (Amount in INR)

Expense description Bill Amount(₹) Non- Payable Amount(₹) Payable Amount(₹)
Miscellaneous Charges 1,000.0 1,000.0 0.0
Nursing Fees 1,500.0 0.0 1,500.0
Medicine & Consumable Charges 10,159.6 1,864.8 8,294.8
Anaesthetists Fee 4,000.0 0.0 4,000.0
Physiotherapy 600.0 0.0 600.0
Icu Charges 1,500.0 0.0 1,500.0
Room Charges 2,500.0 0.0 2,500.0
Ot Charges 10,000.0 0.0 10,000.0
Surgeon Charges 10,000.0 0.0 10,000.0
Premium Emi Recovery Amount 0.0 0.0 0.0
Registration Charges 160.0 0.0 160.0
Consultation Visit Charges 7,200.0 0.0 7,200.0
Procedure Charges 1,500.0 1,000.0 500.0
Investigation Charges 1,910.0 0.0 1,910.0
Grand Total(₹) 52029.6 3864.8 48164.8
Break-Up of the disallowances (Amount in INR)
Disallowed
Bill Number Expense Category Bill Amount(₹) Non- Payable Amount(₹)
reasons
Miscellaneous Service
456 1000.0 1000.0
Charges Charges-1000
Medical Care-
456 Procedure Charges 1500.0 1000.0
1000
Easy Fix
Medium-
Medicine & 47,10ml
7213 1940.71 512.2
Consumable Charges Syringes-
145.2,urobag-
316,needels-4
 Mopp Pad-
200,cotton
Wool 200g-
400,dispo Cap-
90,dispo Mask-
60,pv Gloves-
225,needels-
Medicine & 40,5 M
7252 6784.5 1335.1
Consumable Charges Syringes-
110,10ml
Syringes-
133.1,1m.
Syringes-
30,easy Fix
Medium-47

M Syringe *-
Medicine &
7285 136.17 17.5 10,pv Gloves-
Consumable Charges
7.5
Grand Total(₹) 11361.38 3864.7999999999997 --------
Final Summary of the settlement
Excess Sum Insured(₹) 0
Premium EMI Recovery Amount(₹) 0
Final Amount Payable after deductions(₹) 48,163.0

The final payable amount will be credited within 4-5 working days
Eligible Amount will be settled to the Bank Account details provided by you -5821,Do let us know in case it is
not the correct one.
Once you have received the full amount in your bank account, we will consider this claim to be fully settled. In
case the amount is not received within 4-5 working days, please write to us at hello@godigit.com or
support.healthclaims@godigit.com and we will surely look into it.

Refer the link for Non-Payable items : List of Non-medical Items

Quick snapshot of your policy balance sum insured and past claim details:

A. Balance Sum Insured

Base Sum Insured(₹) 400000.0 Cumulative Bonus(₹) 0.0

Total Sum Insured(₹) 400000.0 Balance Sum Insured(₹) 351836.0

B. Past claim details under the policy no D098815889 for the Policy year 2023-24

Claim
Claim Number Claim Type Diagnosis ClaimAmount(₹) SettledAmount(₹)
Status
Delivery by emergency
202301761696 closed Reimbursement 52029.0 48164.0
caesarean section

If you are not satisfied with the decision, kindly drop us a mail to support.healthclaims@godigit.com nd we will take it
from there.
We assure you the best of our services, always.
Warm Regards,
Team Digit