Health insurers usually ask for the investigation reports that support the diagnosis and treatment being claimed, along with the policy, identity, and hospital documents. Keep the full reports, not summaries, for as long as the policy is active. The policy wording and the insurer's claim list decide exactly what is needed.
Health insurance in India is regulated by IRDAI, and the contract is the policy wording. Two policies can ask for different documents, and a cashless claim follows a different route from a reimbursement claim.
The policy decides
Start with the claim section of your policy and the insurer's claim checklist. A hospital cashless desk and a third-party administrator work from the same policy. If a document is requested, ask which claim stage it is for: pre-authorisation, final settlement, or a review.
What a claim commonly asks for
- A completed and signed claim form.
- The policy copy and identity proof.
- The hospital discharge summary, bills, and payment receipts.
- Investigation reports: laboratory, imaging, and any test that supports the diagnosis.
- Prescriptions and the treating doctor's notes.
- For a reimbursement, proof of payment and the original bills.
Treat this as a common list, not a rule. The insurer may ask for more, and the policy may exclude some treatments or apply a waiting period.
Why lab reports matter in a claim
A lab report can support the diagnosis, show when a condition was first documented, or show the tests behind a treatment decision. For a pre-existing condition or a waiting period, an older report may be as important as the latest one.
Finding a report from years ago
Start with the lab's records desk and the portal, then the hospital where the test was done, the doctor who ordered it, and any earlier claim file. The routes for old reports are covered in detail in the guide on getting old lab reports.
Keeping a claim-ready file
Keep one folder per claim or per policy year. Put the full reports in it, with the date, the lab, and the patient's name visible. Keep a scan as well as the paper if the insurer asks for originals. Note what was submitted, to whom, and when.
| Claim stage | What the report does | What to keep |
|---|---|---|
| Pre-authorisation | Supports the diagnosis and the planned treatment | The latest relevant reports and the doctor's notes |
| Cashless settlement | The hospital submits the file; the report supports it | Copies of everything in your own folder |
| Reimbursement | You submit the file | Full reports, bills, and payment proof |
| Pre-existing or waiting period review | Shows when the condition was first documented | Older reports and the first prescription |
| Renewal or portability | May be requested to continue cover | A summary and the reports behind it |
What not to do
- Do not alter a report or a bill.
- Do not submit a screenshot when the full report is available.
- Do not assume a summary will be accepted in place of the report.
- Do not wait until the last day of the claim window to start looking for a missing file.
Privacy and limits
Sharing a report with an insurer is your decision, and the insurer handles it under its own privacy terms. Doctano is not an insurer or a TPA, does not file claims, and does not decide what is covered. Keep your own copy of everything you submit.