Heritage Health Insurance Claim Status: A Complete Guide by InsuranceMart .
When you buy a health insurance policy, your real relationship with the insurer begins at the time of claim. One of the most trusted names in India’s health sector is Heritage Health Insurance TPA (Third Party Administrator) — the service partner that manages claim processing for several major insurance companies.
If your insurer uses Heritage as a TPA, understanding how to check your claim status and ensuring smooth claim settlement is essential. This guide by InsuranceMart explains every step clearly.
What Is Heritage Health Insurance TPA?
Heritage Health Insurance TPA Pvt. Ltd. (HHITPA) is an IRDAI-licensed Third Party Administrator that connects insurance companies, hospitals, and policyholders.
Their responsibilities include:
- Managing cashless and reimbursement health claims
- Maintaining health records for insured members
- Coordinating with hospitals for claim approvals
- Offering customer support for queries and status updates
When your insurer partners with Heritage TPA, all claim communications and verifications are handled by them — from hospitalization intimation to final payment.
Types of Heritage Health Insurance Claims
1. Cashless Claim
If you are admitted to a network hospital, you can avail a cashless facility. Heritage directly settles bills with the hospital.
Steps to Avail Cashless Claim:
- Present your Health Card / TPA ID at hospital desk
- The hospital sends pre-authorization to Heritage
- Heritage verifies details and approves
- The hospital receives direct payment from TPA
2. Reimbursement Claim
If you get treated in a non-network hospital, you can apply for reimbursement after discharge.
Documents Required:
- Original hospital bills and receipts
- Discharge summary
- Doctor’s prescriptions and test reports
- Investigation bills and payment proofs
- Policy copy and ID proof
Once verified, Heritage transfers the amount directly to your bank account.
Claim Status Terms and Their Meaning
| Status | Meaning |
|---|---|
| Received | Claim documents received by Heritage TPA |
| Under Process | Claim is being reviewed and verified |
| Query Raised | Additional documents or clarifications needed |
| Approved | Claim approved for payment |
| Settled | Payment made to hospital or insured |
| Rejected | Claim denied due to exclusion or incomplete information |
Common Reasons for Claim Delays or Rejections
Even a small mistake can cause claim delays. Common issues include:
- Incomplete or missing medical documents
- Non-disclosure of pre-existing illness
- Room rent exceeding sub-limit
- Treatment not covered under policy
- Late claim intimation beyond allowed period
How InsuranceMart Helps You with Heritage Health Insurance Claims
At InsuranceMart, we understand that medical emergencies already bring emotional stress — claim processes should not add to it.
That’s why our expert Claim Assistance Team personally supports you throughout your Heritage Health Insurance claim journey.
Our Support Includes:
- Hospital Coordination: Direct communication with hospitals and Heritage TPA for faster approvals
- Document Verification: We ensure all required documents are correct and complete
- Claim Appeals: If your claim is rejected or underpaid, we fight for a fair outcome
- Regular Updates: You are informed about every stage until final settlement
Because at InsuranceMart, your health claim is our personal responsibility, not just a file.
Documents Required for Heritage Claim
For Cashless Claims
- Policy / TPA Health Card
- Doctor’s admission note
- Photo ID proof
- Hospital registration documents
For Reimbursement Claims
- Original hospital & pharmacy bills
- Discharge summary
- Prescriptions & test reports
- Bank details for claim transfer
- Any additional document requested by Heritage
How Long Does It Take to Process a Heritage Claim?
- Cashless Claims: 2–6 hours (depending on hospital approval)
- Reimbursement Claims: 7–15 working days after submission
At InsuranceMart, we track your claim regularly and ensure timely follow-ups with Heritage TPA for smooth closure.
Why Choose InsuranceMart for Your Health Insurance Support
- 25+ Years of Experience in claim management and consultation
- Dedicated Claim Experts who assist in every case
- Full Transparency — we explain every clause and exclusion before you buy or claim
- Empathy First Approach: We’ve personally experienced claim rejections — that’s why we fight harder for yours
- End-to-End Support: From hospitalization to settlement, InsuranceMart stays with you throughout
Conclusion
Heritage Health Insurance TPA ensures reliable claim handling — but even then, technicalities or incomplete paperwork can cause issues.
With InsuranceMart as your claim advisor, you never have to face this alone.
Our mission is simple: to make sure your claim is settled quickly, fairly, and fully.
When life takes an unexpected turn, InsuranceMart stands beside you — as your guide, your advocate, and your support system.
Need help checking your Heritage claim status or resolving a pending claim?
👉 Contact InsuranceMart today
