What is Heritage Health Insurance? Guide 2025

What is Heritage Health Insurance?

Heritage Health Insurance, an IRDAI-licensed service provider, is a third-party administrator (TPA) that operates with 19 offices across India. Heritage Health manages cashless approvals and claim processing. It also offers customer support and hospital networking for multiple insurers. Insurers such as National Insurance Company and United India Insurance Company utilize their services.

Introduction

Looking for a reliable TPA to simplify your health insurance claim process? Heritage Health Insurance helps policyholders manage claims smoothly and connect with hospitals nationwide. At Ditto, we simplify such decisions and help people make the right choice.

This guide helps you understand:

• Heritage health insurance benefits and claim process
• Documents required for claims and how to track your claim
• Should you opt for a TPA

Need help purchasing a health insurance policy? Book a free consultation call with us and our expert advisors will help you out.

Heritage Health Insurance TPA: Overview

Heritage Health Insurance was founded in 1998 and later became a TPA after IRDAI introduced TPAs in 2001. It is part of the S K Bajoria Group. The organization has grown steadily over the years under the leadership of its CEO, Mr Sunil Parakh.

Policyholders get to choose from 5,000 network hospitals in India, and for overseas mediclaim policies, 15,000 network providers across the globe.

Did You Know?

Heritage Health Insurance offers a simple BMI tool that helps you check if your weight is in a healthy range and understand related health risks.

What is the Cashless Claims Settlement Process at Heritage Health Insurance?

Cashless treatment is where Heritage will directly settle hospital bills on your behalf. Here is the step-by-step flow:

1. Select a hospital from Heritage Health’s network list and show the Heritage ID Card at the hospital. 
2. The hospital then sends a cashless treatment request using the required pre-authorization form. Here’s what the form looks like.
3. Heritage reviews the request carefully, and they issue an authorization letter to the hospital confirming approved payment.
4. After treatment and discharge, the hospital collects all original documents related to the case.
5. The hospital submits these documents to Heritage, and once verified, Heritage directs the insurer to pay the hospital directly.

Note: In an emergency hospitalization, the patient can get admitted to a network hospital first and follow the steps afterwards.

What is the Reimbursement Claims Settlement Process at Heritage Health Insurance?

You file a reimbursement claim when you go to a non-network hospital or when the hospital does not support cashless treatment. Here is the process:

1. Inform Heritage about the hospitalization, preferably before getting admitted or at the most within 24 hours of being hospitalized.
2. Collect all the invoices generated by your hospital and pay the final bill from your own pocket.
3. Post-discharge, file the claim settlement form and submit it to your insurer. Here’s what the reimbursement form looks like.
4. Once the insurer reaches out to you, submit the documents within 7 days.

What Documents Are Required to Be Submitted to Heritage Health Insurance for a Reimbursement Claim Settlement?

Here’s the list of documents required for reimbursement claim submission:

• Duly filled in claim form. 
• Bills/receipts and discharge certificate/card from the hospital. 
• Submit hospital and pharmacy bills with valid prescriptions.
• Provide lab test reports with a note from the doctor explaining why the tests were needed.
• Include the surgeon’s certificate, surgery details, and all doctor or specialist bills, receipts, and diagnosis notes.
• Certificate from an attending medical practitioner/surgeon stating that the patient is fully cured. 
• Copy of Heritage card and copy of the policy schedule

Take Note: IRDAI warned Heritage Health in 2025 for claim-handling issues. They closed claims without proper proof and also sent decisions that insurers should send. Read more about it.

How Do I Track the Claim Status with Heritage Health Insurance?

Tracking your claim is super simple:

1. Visit the online portal for tracking your policy claim.
2. Enter the CNN card or employee number.
3. Submit and check status.

How Do I Contact Heritage Health Insurance?

You can reach them easily through any of the following ways:

1. You can call their All India Toll Free Number 1800-345-3477.
2. You can drop a mail at heritage_health@bajoria.in
3. You can reach out to their website, and as per your residence, you can contact them.
4. If you are a senior citizen, you can call their emergency helpline at (033) 4014 5100.

Ditto’s Take on TPAs

At Ditto, we do not work with TPAs. If you still want to choose one, pick a TPA with a strong hospital network and a good record of handling genuine claims without trouble. 

That said, insurers with their own in-house claims team for retail plans are usually a better option. They handle the entire process directly, which makes approvals faster and more reliable. You avoid multiple touchpoints and get smoother coordination with hospitals. In case you bought a policy through us, contact us here.

Why Talk to Ditto for Your Health Insurance?

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Rajan below love us:

• No Spam & No Salesmen
• Rated 4.9/5 on Google Reviews by 15,000+ happy customers
• Backed by Zerodha
• 100% Free Consultation

You can book a FREE consultation. Slots are running out, so make sure you book a call now.

Final Thoughts

You cannot pick Heritage Health Insurance as your TPA on your own; it is decided by your insurer. So, focus on the insurer’s claim track record and hospital network. If needed, check if switching TPAs is allowed. You should verify that claim decisions and communications come only from your insurer, not the TPA, especially after IRDAI warned Heritage TPA against unilaterally closing health claims without consulting the insurer.

Still unsure about choosing the correct insurer? Book a free call with us and let our experts guide you in making an informed decision.