TCS India - Health Insurance Scheme (HIS) - Claim Guidelines

Accessing Medi Assist Portal

You may access the Insurance portal by logging in to:
Ultimatix -> Employee Services -> Health & Wellness -> Medi Assist.
Note: Link should be opened using only Internet Explorer (IE) 8.0 and above or Google Chrome and
ensure the cookies, browsing history and Cache is deleted.
If you have forgotten your Ultimatix Password then please contact the Global Helpdesk or Email:
Ultimatix.helpdesk@tcs.com
Phone: 60605555/022-25188155 Buzz (VoIP): 500 5555
Important guidelines for processing of HIS Claims

Staple and number the Claim Form along with supporting documents (in case of multiple
claims, staple them separately and mention the number of documents).
Raise separate Claim requests for each illness.
Write your employee ID and HIS Claim category either Domiciliary and/ or Hospitalisation
and mention the total number of claims on the envelope containing the documents. Ensure
each supporting document has employee ID and Claim number written on it.
Retain the scanned or photo copies of all the documents to produce them if/ when required.
Submit the original documents along with the duly filled Claim Form in the drop-box at TCS
office location (Refer Contact Matrix).
Submit the Claim documents within 7 days from the Claim Request Generation date; else the
Claim request will be rejected.

Hospitalization Claim
Hospitalisation benefits are applicable only if the insured person is admitted to a hospital
continuously for a minimum of 24 hours (with exception to Day Care Procedures mentioned in the
policy).
Following are the mandatory documents for processing the Hospitalisation Claims:

Duly filled and signed Claim Form as generated through the Medi Assist portal.
Original and detailed admission or discharge summary/card issued by the hospital with
details line of treatment
Detailed hospital bills along with break-up bill of all hospitalisation expenses
Original and pre numbered bill/receipt/cash memo issued by the hospital
Copies of all investigations, lab or test reports (wherever applicable) from hospitals or from
any other lab or diagnostic centres during and before or after the hospitalisation.
Original medical bills or receipts with prescriptions for the medicines purchased from the
pharmacy store
Copy of FIR/ MLC in case of accidental claim

Domiciliary and Domiciliary Dental Claim

Domiciliary treatment covers all illnesses (subject to policy conditions) that do not require
hospitalisation including treatments taken either from a physician or at the OPD in a hospital.
Domiciliary Dental claim will only cover expenses towards extraction, fillings, medicines, consultants
fees, and X-rays.
Following are the mandatory documents required for processing the Domiciliary/Dental Claims:

Duly filled and signed Claim Form as generated through the portal.

Doctors prescription with details of the nature and duration of illness. (Ailment should be
mentioned on the prescription)No payment details should be mentioned in this document

Original pre-numbered bills from the doctors official receipt book, with pre-printed
doctors information and receipt number. Blank document with the doctors signature and
stamp will not be considered as a receipt proof
Note: Doctors prescriptions/ letter head bills will not be accepted by the insurance
company
Original medical bills or receipt along with prescriptions for the medicines purchased from
the pharmacy stores
Note: The bills or receipts produced should be within the policy period
Copies of all investigations/ labs/ test reports (wherever applicable) from hospitals or from
other lab or diagnostic centres during and before or after the hospitalisation
Note: Prescription for the particular financial year only will be considered as valid
Dental Treatment: Day-to-day case summary (day-wise treatment undergone during the
entire cycle of the treatment) in case of Root Canal or other dental treatment where
multiple visits or sittings are being carried out
Dental Treatment: X-ray film or X Ray reports