Question 1

Is EzeeClaims related to Ezee Technologies or any other similarly named company?

Accepted Answer

No. EzeeClaims is an independent, standalone platform - it is not affiliated with, owned by, or operating under Ezee Technologies or any other company or product with a similar name. Any information suggesting otherwise refers to an unrelated company that happens to share part of the name.

Question 2

Is my medical and personal data safe?

Accepted Answer

Your documents are encrypted and only used to check your claim. We never sell or share your data, and you can request deletion of your records at any time.

Question 3

How is my risk score worked out?

Accepted Answer

We go through your documents and tell you what's missing or incomplete, so you can fix it before you send them to your insurer.

Question 4

Do I need to sign up just to check my risk?

Accepted Answer

No sign-up needed for your first check. Upload your documents and get your score right away. You can always create an account afterwards too, if you'd like to save your results and come back to them later.

Question 5

What happens after I check my claim?

Accepted Answer

You'll see exactly what's missing or risky, in plain language. Fix what you can yourself, or tap into human expert support if you'd like extra help before you submit.

Question 6

Why do health insurance claims get rejected, and how can I avoid it?

Accepted Answer

Most rejections come down to a handful of avoidable things: missing documents, mismatched dates between your bill and discharge summary, policy exclusions nobody checked, or an incomplete claim form. That's exactly what we check before you submit, so you can fix the avoidable stuff instead of finding out after a rejection.

Question 7

How do I check my claim status?

Accepted Answer

Your insurance company or TPA is the one that shares claim updates, through their own portal, SMS or helpline. EzeeClaims does not track claim status. What we do is check your documents before you submit, so your claim is less likely to get stuck in a query later.

Question 8

What's an itemised bill, and why does it matter for my claim?

Accepted Answer

An itemised bill breaks down every charge line by line instead of one lump total. Insurers often ask for this before they'll process a claim. We check whether your bill is itemised properly as part of your audit, so a missing breakdown doesn't hold up your claim later.

Question 9

What's pre-authorization, and is it different from final approval?

Accepted Answer

Pre-authorization is the hospital's advance approval for a planned admission. It isn't the same as your final claim being approved. Even with pre-auth in hand, your insurer can still review the actual bill at discharge, so we check both stages, not just the paperwork you got upfront.

Question 10

What is the difference between a TPA and an insurance company?

Accepted Answer

A TPA (Third-Party Administrator) is the company that handles claim paperwork. The insurance company makes the final decision on the claim. They are not always the same organisation, and some insurers process claims in-house with no TPA at all. Both names are usually printed on the health card, and we pick them up from your documents during the check.

Question 11

My claim was rejected. What can I do?

Accepted Answer

A rejection is not always final. There is a set path you can follow.

Step 1: Contact your insurance company's customer service, through their website, helpline or a branch office. The contact details are in your policy document.

Step 2: If that does not settle it, raise a formal grievance with the insurance company through their grievance page.

Step 3: If you are still not satisfied, register the complaint with IRDAI on the Bima Bharosa portal at https://bimabharosa.irdai.gov.in/ where you can also track its status.

Step 4: If the outcome still does not meet your expectations, you can approach the Insurance Ombudsman. The addresses are in your policy document and at https://www.cioins.co.in/

You are also entitled to ask exactly which policy clause was used for any deduction or rejection. The insurance company has to be specific, not vague.

Question 12

Is there a checklist for what documents I need for a health insurance claim?

Accepted Answer

Yes, final bill, discharge summary, all paid receipts, pharmacy bills, lab reports, KYC documents, your insurance ID card, and bank details for reimbursement, plus any consultation papers. Upload what you have and we'll tell you exactly what's still missing for your specific claim.

Question 13

How does the mediclaim reimbursement process work in India?

Accepted Answer

For reimbursement claims, you pay the hospital first, then submit your bills and documents to your insurer to be paid back, unlike cashless, where the hospital bills the insurer directly. Since there's no hospital TPA desk double-checking things for you in reimbursement, having every document complete before you submit matters even more, which is exactly what we check.

Question 14

What is claim settlement ratio, and does it matter?

Accepted Answer

It's the percentage of claims an insurer actually settles out of all claims filed in a year. A useful signal of how reliable an insurer is, published annually by IRDAI. It won't tell you whether your specific claim will be approved, but a complete, well-checked claim gives you the best shot regardless of the insurer's overall ratio.