About Us

East West Assist Insurance TPA Private Limited (IRDA License No.18 Validity from 16-05-2020 to 15-05-2023) is a dedicated Third Party Administrator (TPA) Health Services, licensed by the Insurance Regulatory & Development Authority (IRDA) on May 16, 2002. It comes into the market backed by the vast experience and skills of the East West Group.

About Us

The company provides third party administration in healthcare services, which include designing medical plans, administering healthcare claims and providing managed healthcare services to the Insurance Companies and Corporations.

Claim Status

Card Status

Register Claim

Grievance

Services

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IRDAI/Hospital Empanelment

Overview

5000+ Care Provider

500+ Locations

29 States

1.25 Million Claim Encounters

100% Retention of all stakeholders

97% Settlement Ratio

2.5 Million Calls

Claim TAT 5 Days - Retails 2 Days - Corporate

Card TAT 5 Days - Retails 2 Days - Corporate

100% Retention of all stakeholders

100% Retention of all stakeholders

Benefit

DIGITAL & PLASTIC CARDS

Online Policy Download via SFTP.
14-Seater dedicated Data Entry Cell.
Online/Mobile enabled E-cards.
Online IT/Enrolment support,Smartphone Claim App.
7 Days Physical Card Issuance TAT.
Capacity: 2500-3000 Cards per day.
TPA Dedicated Card Helpline number and WhatsApp Support -
+91—9599286872,011—47222131,136

IT & MIS SYSTEM

Efficient and defined team of Software engineers and Data analysts with minimum 4 years of experience
All data analysis and MIS available as per IRDA and underwriters
Daily intimation reports, timely software and database upgrades, Live claim view
LAMP Technology-Linux,Apache,MySQL and PHP
Insurer DO, BO, RO, HO - Login System Access
Customizable real-time claim and MIS dashboards

CLAIMS PROCESSING SERVICE (Insurer Benefits)

Increased benefits to Insurers

Meaningful product differentiator
Increased customer retention
Increased sales - Higher Close Ratio
Reduction in Loss Ratio
Speedy settlement of claim

Reduced Claims / TAT’s for Insurers

Cost containment for insurers
Reduction in Claims - Lower Claim Ratio

CLAIMS PROCESSING SERVICE (Consumer Benefits)

Reduced Claims / TAT’s for Insurers

Increased benefits for Customers
Proactive & Responsive TPA
Hassle free cashless service
Peace of Mind
24 Hours Emergency Assistance
Focused & Personalised Service
Optimal level of medical care

Investigation, Fraud &
Abuse Management

MAIN TRIGGER POINTS

POLICY & CLAIM TRIGGER

DIAGNOSIS OR SURGERY SPECIFIC TRIGGER

PROVIDER LOCATION OR PROFILE TRIGGER

BILLING AND TARIFF BASED TRIGGERS

Claim Trigger
Investigate
data & analytics
Study Pattern
Report
Red Flag/Caution list/ Book the case
Share with All stakeholders

Name	Action
United Insurance Co. Ltd.	View Public Disclosure
National Insurance Co. Ltd.	View Public Disclosure
Iffco Tokio General Insurance	View Public Disclosure
The Oriental Insurance Co Ltd	View Public Disclosure

Name	Action
Care Health Insurance	View Public Disclosure
National Insurance Co.Ltd.	View Public Disclosure
Iffco Tokio General Insurance	View Public Disclosure
The Oriental Insurance Co Ltd	View Public Disclosure
United Insurance Co. Ltd.	View Public Disclosure

Disclosure 2019-20 : Public disclosure on the qualitative and quantitative parameters of the health services rendered to policyholder of 2019-2020

Insurance Company List

Name Action

United Insurance Co. Ltd. View Public Disclosure

National Insurance Co. Ltd. View Public Disclosure

Iffco Tokio General Insurance View Public Disclosure

The Oriental Insurance Co Ltd View Public Disclosure

Disclosure 2020-21 : Public disclosure on the qualitative and quantitative parameters of the health services rendered to policyholder of 2020-2021

Insurance Company List

Name Action

Care Health Insurance View Public Disclosure

National Insurance Co.Ltd. View Public Disclosure

Iffco Tokio General Insurance View Public Disclosure

The Oriental Insurance Co Ltd View Public Disclosure

United Insurance Co. Ltd. View Public Disclosure

Hospital Network List - Last Updated On 17th Dec 2021 East West Assist Insurance TPA Private Limited Certificate of Registration, IRDA Licence No. 018, Validity from 16-05-2020 to 15-05-2023 , Cashless Hospitalization Service , Reimbursement Claim Service , Show All Covid Hospitals

East West Assist Insurance TPA Private Limited Certificate of Registration,
IRDA Licence No. 018,
Validity from 16-05-2020 to 15-05-2023

East West Assist Insurance TPA Private Limited:

Helpline Numbers
Senior Citizen Cell	admin@eastwestassist.com	011-47222647

Sno	Updates	Last Updated On
1	EWA TPA IOS App (New)	03-03-2015
2	EWA TPA Android App (New)	27-02-2015
3	EWA TPA Windows App (New)	27-02-2015
4	First Aid for Anyone Anywhere	20-01-2014
5	Health and Travel health	20-01-2014

Escalation Matrix

HEAD OFFICE: DELHI

38, Golf Links
New Delhi-110003

OPERATIONS

East West Assist Insurance TPA Private Limited

2nd floor, J P House Plot No.172, Lane 2, Westend Marg,
Saidulajab, Next to Saket Metro Station New Delhi—110030

Ph: +91-11-47222666 



Email: assistance@eastwestassist.com

REGIONAL OFFICE: JAIPUR

SF-50,CROSS ROAD,MALL (2nd FLOOR ),
CENTRAL SPINE,VIDADHAR NAGAR,OPP.ICICI BANK,
JAIPUR—302039
Ph: +91-141-2338848

Email : ewa.jaipur@eastwestassist.com

REGIONAL OFFICE : MUMBAI

91 Springboard Business Hub Pvt. Ltd.

74/II, D Cross Road,
Opp Gate No. 2, MIDC,

400093, Seepz, Andheri East, Mumbai,

Maharashtra - 400069

REGIONAL OFFICE : PUNE

Springboard Solutions Pvt. Ltd. 

Clockhouse, Creaticity Mall, Opposite Golf

Course, Off, Airport Rd, Shastrinagar,

Yerawada, Pune, Maharashtra - 411006

REGIONAL OFFICE : BENGALURU

91 Springboard Business Hub Pvt.Ltd. 

George Thangaiah Complex, #21, 80 feet road,

near Sir CV Raman Hoapital,

Indiranagar, Bengaluru - 560038

For Senior Citizen Cell

Email: admin@eastwestassist.com, Phone Number:011-47222647

For Cashless

Email: cashless@eastwestassist.com, Phone Number:011-47222601,615,626 | 7838807980

For Grievances

Email: grievance@eastwestassist.com, Phone Number: 011-47222620

For Cards:

  Email: cards@eastwestassist.com, Phone Number: 011-47222631|9711779711

For Hospital enrolment

Email: network@eastwestassist.com, Phone Number: 011-47222628|011-47222602

For Reimbursement

Email: reimbursement@eastwestassist.com, Phone Number: 011-47222666,634,638,6113 | 9711779711

Sno	Updates	Last Updated On
1	EWA TPA IOS App (New)	03-03-2015
2	EWA TPA Android App (New)	27-02-2015
3	EWA TPA Windows App (New)	27-02-2015
4	First Aid for Anyone Anywhere	20-01-2014
5	Health and Travel health	20-01-2014

Sno

Updates

Last Updated On

EWA TPA IOS App (New)

03-03-2015

EWA TPA Android App (New)

27-02-2015

EWA TPA Windows App (New)

27-02-2015

First Aid for Anyone Anywhere

20-01-2014

Health and Travel health

20-01-2014

Name	Designation	Email ID’s	Phone Number
Parikshit Mahajan	Chairman & Managing Director	pmahajan@eastwestassist.com	011-47222624
Dr. Atul Arora	Chief Executive Officer	ceo@eastwestassist.com	011-47222623
Umang Palta	AVP Float & Admin	umang@eastwestassist.com	011-47222621
Sabina Sehgal	AVP Banking & Disbursements	sabina@eastwestassist.com	011-47222614
Dr R.K Bhat	Chief Medical Officer	cmo@eastwestassist.com	011-47222619
Dr. Prashant	Head Claims and Cashless	drprashant@eastwestassist.com	011-47222622
Stuti Singhal	Manager- Operations	stuti@eastwestassist.com	011-47222630
Jai Shankar	Regional Manager-NDRO	shankar@eastwestassist.com	011-47222617
Hemant Kumar	Coordinator – Card Department	cards@eastwestassist.com	011-47222631

Helpline Numbers
24 Hour Help Desk	assistance@eastwestassist.com	011-47222666
Senior Citizen Cell	admin@eastwestassist.com	011-47222647
Cashless Department	cashless@eastwestassist.com	011-47222601,602,615 \| 7838807980
Card Department	cards@eastwestassist.com	9958592522
Reimbursement	reimbursement@eastwestassist.com	011-47222666,634,638,6113,602 \| 9711779711
Grievances	grievance@eastwestassist.com	011-47222620
Hospital Enrolment	network@eastwestassist.com	011-47222628

Phone Number
Tel: AIRTEL :- 47222666(100 line)

Phone Number

Tel: AIRTEL :- 47222666(100 line)

Helpline Numbers
Senior Citizen Cell	admin@eastwestassist.com	011-47222647

Helpline Numbers

Senior Citizen Cell

admin@eastwestassist.com

011-47222647

Name of hospital*:		Address*:
State*:		City*:
Hospital Registration number*:		IRDA Unique identification:
PAN Card number*		Specialties*
Phone no.*:
Email*:		Website:
No. of in-house doctors *:		No. of outside consultants*:
Total no. of beds*:		Tariff discount(minimum 10%)*:
List of tpa :		Name of Medical Director *:
Medical Director Email*:		Contact number / Mobile *:
Name of medical superintendent *:		Contact number / Mobile *:
Name of TPA Coordinator*:		Contact Number/Mobile*:

Escalation Matrix
Contact Person Name*:		Email*:
Contact Number/Mobile*:
In case of emergency / notification calls from our organization to your hospital, the Person to contact
Name*:		Contact Number/Mobile*:
Name of Financial Officer / Accounts officer *:		Contact number / Mobile *:

Full name of patient	Age
Sex	Residential address
Name of insurance company/ corporation	Policy number
Identification card number	Dates of validity
Name of Hospital	Name of treating doctor
Contact phone numbers of treating physician/surgeon	Patients location in the hospital/ bed number/ room number
With extension number of bedside telephone	Date and time of admission
Working diagnosis	Medication given and investigations done at the time of informing EWA
Approximate daily cost	Likely number of days the patient may be hospitalized
If any family members or companion is with the patient.

Are the following available	Yes	No		Yes	No
Imaging
X-ray			Doppler
Ultrasound			CT scan
MRI			Barium studies
Laboratory
Hematology			Biochemistry
Serology			If in-house ABG (arterial blood gas examination) not available. Is it possible to send the sample elsewhere?
Histopathology			HIV 1
HIV 2
Cardiology
Electrocardiograph			Echo
Defibrillator			Cardiac monitor
Pacing – Temporary			Permanent
TMT			Holter

Are the following available	Yes	No		Yes	No
Emergency
Emergency room			24 hour resident in the hospital
Specialists on call			Or present 24 hour in the hospital
Nephrology
Peritoneal Dialysis			Hemodialysis
Renal transplant
Gastroenterology
Endoscopy			Colonoscopy
ERCP
Neurology
EEG (electro encephalogram)			Sleep lab
EMG / NCV (electro myelogram / nerve conduction studies)
Orthopedics
Acute Trauma can be rapidly operated			Joint replacement

East West Assist Insurance TPA Private Limited

We will
help through
every step

Claim Status

Card Status

Register Claim

Grievance

Services

Downloads/
Uploads

IRDAI/Hospital Empanelment

Overview

Benefit

Investigation, Fraud &
Abuse Management

Claim Intimation

MOU signing date :	Validity
Form filled by *:
Signature* (Signature must be less than 20 KB and dimension 200x50):
Designation*:

Signed for EWA		Signed for Hospital
Signature		Signature*(Signature must be less than 20 KB and dimension 200x50) :
Name		Name* :
Title/Designation		Title/Designation* :
Date:		Name of Hospital/Nursing home/clinic* :
		Date*:

Copy of hospital registration certificate/copy of shop/commercial (whatever applies)		Pollution certificate*
ISO certificate (if applicable)		Registration of Chief doctor*
Schedule of charges(Package rates). in excel format only*		Cancelled bank check*
Photographs of facilitates-Hospital entrance, general ward, Operation Theater, ICU/NICU, generator sets*

TPA Login	Corporate Login
Advisor Login	Hospital Login
Broker Login	Individual Login
Insurer Login

We will help through every step

Claim Status

Card Status

Register Claim

Grievance

Services

Downloads/ Uploads

IRDAI/Hospital Empanelment

Overview

Benefit

Investigation, Fraud & Abuse Management

Senior Citizen Cell

Claims

Claim Intimation

Claim Registration

Query Reply

Other Document

We will
help through
every step

Downloads/
Uploads

Investigation, Fraud &
Abuse Management