Aditya Birla Health Insurance Claim Settlement Ratio

One of the most reliable insurance providers in the business, Aditya Birla Health Insurance has a claim settlement ratio of a remarkable 94%. Health insurance claim settlement ratio or CSR, refers to the total percentage of insurance claims that an insurance provider settles out of the total number of claims received in a given period. Here is the formula for claim settlement ratio:

Claim Settlement Ratio = (No. of claims settled in the year/No. of claims received in the year) x 100

The higher the claim settlement ratio of an health insurance company, the higher the chances that your claim will be approved.

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Aditya Birla Health Insurance Claims

When looking to buy a health insurance plan, one of the most important factors you must consider is the ‘Claim Settlement Ratio’ of the insurance company. You also need to thoroughly understand the claim settlement process of the insurance company you choose. This will make it much easier for you to register claims with your insurance provider and get your claims approved. In this article, we’ll take a look at the Aditya Birla health insurance claim settlement ratio as well as their claim settlement process.

List of Aditya Birla Health Insurance Plans with Claim Settlement Ratio 

Aditya Birla health insurance claim settlement ratio is 94%. This is one of the reasons why the company has a huge customer base of more than 10 million. Check out the list of some of the popular health insurance plans of Aditya Birla Sun Life Insurance:

 

Health Insurance Plans

Premium Rate

Features 

Check Plans

 

 

 

 

 

 

 

Activ Assure Diamond Health Insurance Plan

 

 

 

 

 

 

 

₹6,371/ annum

  • Enjoy annual health-check ups and no claim bonus benefits

  • Feature of worldwide emergency assistance service available. It helps in safe transportation of patient to any hospital of the world and back to home

  • Day care treatments available

  • In patient hospitalisation expenses and organ donor expenses covered

  • Pre and post-hospitalisation expenses covered

 

 

 

 

 

 


 

 

 

Activ Fit Health Insurance Plan

 

 

 

₹6,863/ annum

  • Applicants below the age of 35 years enjoys a better premium rate and discount

  • Covers maternity benefits

  • Applicants below the age of 18 years enjoy 10% discount on passing the health risk assessment

  • Daily cash benefit offered

  • Dar care treatments and in-patient hospitalisation expenses available 

 

 

 


 

 

 

 

Activ Care Classic Health Insurance Plan

 

 

 

 

₹28,373/ annum

  • Enjoy comprehensive health check-up every year at any network hospital

  • No claim bonus benefits

  • AYUSH expenses covered

  • Enjoy the benefits of a personal health coach

  • Cashless claims can be raised for home treatments like that for dengue, hepatitis, chemotherapy, etc. 

  • Pre and post-hospitalisation expenses covered

 

 

 

 

 

 

 

 

 

 

Activ Health Platinum Essential Health Insurance Plan

 

 

 

 

₹5,390/ annum

  • Enjoy 30 days pre-hospitalisation and 60 days of Post-hospitalisation medical expenses cover

  • Avail the benefits of an expert health coach for health, fitness, etc. 

  • Day care treatment expenses covered

  • In-patient hospitalisation and domiciliary hospitalisation expenses covered

  • Pre and post-hospitalisation expenses covered

 

 

 

 

 

 

How to File Aditya Birla Health Insurance Claim Online Through Bajaj Markets

Filing health insurance claims was never so simple. Just follow these steps and you’re done!

 

  1. Register your claim through Bajaj Markets online.

  2. Upload the necessary documents.

  3. Your insurer will assess the claim.

  4. Check claim status online.

How does Aditya Birla Claim Settlement Ratio Benefit Policyholders?

Are you wondering how a high claim settlement ratio will benefit a policyholder? Aditya Birla Claim Settlement Ratio is undoubtedly good news for all its health insurance customers. Let's understand why it is beneficial for policyholders:

  • A high claim settlement ratio directly states a company's ability to settle claims raised by its customers. Aditya Birla claim settlement ratio of 94% means that out of 100 cases, 94 claims are settled properly

  • Claim settlement ratio of a company also impacts its overall market reputation. A company with a high claim settlement ratio is likely to bag a better market image and attract more customer

Statistics say a lot about the way a company functions. Aditya Birla health insurance claim settlement ratio of 94% also indicates that the terms of the company are functioning properly which is why it is able to settle the maximum number of claims raised every policy year.

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Types of Aditya Birla Health Insurance Claims

As Aditya Birla health insurance claim settlement ratio is so high, there are two types of health insurance claims you can choose from

 

  • Cashless Claim

  • Reimbursement Claim

Let’s take a deeper look into these two Aditya Birla health insurance claim processes.

What are Cashless Claims?

Ever been stuck in a medical emergency and were low on cash? Such an uncertain health emergency can drill a hole in your pocket and exhaust your savings! Here's when a health insurance plan with cashless claim settlement acts as a saviour. Under a cashless facility, your insurer directly settles the medical bill with the hospital without you having to pay the bills first. The Aditya Birla health insurance plans are no different. With a cashless treatment facility available at its wide network of 6,500+ hospitals, you need not worry about those hefty hospital bills!

 

Aditya Birla Health Insurance has simple procedures that enable a hassle-free cashless claim process. All you need to do is:

 

  1. Inform Your Insurer
    In case of planned hospitalisation, inform your insurer at least 1-2 days in advance and in case of an emergency, notify them within 24 hours.

  2. Submit Documents
    Submit the required documents like your health card, identity card and medical report.

  3. Insurer’s Assessment
    Your insurance company will verify the details against your health insurance policy coverage and terms.

  4. Claim Decision
    If your claim request is within the coverage, the insurance company will send the approval to the hospital for the specified amount and the hospital will then start your treatment under the cashless treatment facility.

Documents Required for Filing Cashless Claim

Keep the following documents handy when filing a cashless claim with Aditya Birla Health Insurance:

 

  • Duly filled Aditya Birla health insurance claim form

  • Photo ID and age proof

  • Original discharge card of the hospital/day care summary/transfer summary

  • Previous consultation papers mentioning medical history and treatment details for current ailment

  • All the original final hospital bills with all original payment receipts

  • All original diagnostic reports, medical practitioner’s prescription and invoice/bill with payment receipt from the diagnostic centre

  • Duly filled CKYC form which is signed by the proposer (For claims above ₹1 Lakh)

  • All Original Pharmacy and medicine bills along with doctor’s prescription

What are Reimbursement Claims

Under reimbursement claims, you must pay all the hospital bills and expenses out of your pocket initially. You also need to carefully record and store all the hospital and pharmacy bills. Once the treatment is complete and you are discharged, the insurance company reimburses you (the policyholder/insured) for your medical expenses. The reimbursement is done on the basis of providing accurate medical bills and expenses to the insurance company.

 

As a result, reimbursement claims are a bit more time-consuming when compared to cashless claims. However, you can opt for reimbursement claims for treatments done in non-network hospitals. Aditya Birla claim settlement ratio of 94% ensures that you can easily get your claim settled.

 

When making a reimbursement claim, follow the steps below –

 

  1. Intimate the Insurer
    Inform your insurance provider about the hospitalisation and intent to file a reimbursement claim.

  2. Submit Documents
    After the necessary medical treatment, submit the documents like claim form, discharge summary, medical bills, and OPD expense bills with your insurance company.

  3. Claim Verification
    After verifying the documents against the claim, your insurance provider will either accept or deny your claim request.

  4. Claim Decision
    If the claim is approved, the said amount is disbursed and will be deposited in your registered bank account.

Documents Required for Filing Reimbursement Claim

You will need the following documents when filing a reimbursement claim with Aditya Birla Health Insurance:

 

  • Duly completed claim form

  • Photo ID and age proof

  • Original discharge card/day care summary/transfer summary

  • Original final hospital bills with all original payment receipts

  • All previous consultation papers indicating medical history and treatment details for current ailment

  • All original diagnostic reports along with doctor’s prescription and invoice/bill with receipt from the diagnostic centre

  • All original medicine/pharmacy bills along with doctor’s prescription

  • Cancelled cheque copy for proposer with pre-printed name. In case the name is not pre-printed, please provide a copy of the bank passbook/bank statement

  • Duly filled CKYC form which is signed by the proposer (For claims above ₹1 Lakh)

Why Your Aditya Birla Health Insurance Claims May Get Rejected

Here are some reasons why the claims on your health insurance policy may get rejected:

 

  • Misinterpreted Details
    In case any incorrect details and information are provided during the claim, the claim stands rejected as the insurer assesses the claim as per the details provided.

  • Excluded Incident
    In case you file a claim for an incident that is excluded from your health insurance policy, your claim may get rejected.

  • Inactive Policy
    In case you file a claim after your policy has lapsed, your claim would be denied.

  • Delay in Intimation
    In case you fail to inform the insurer regarding the incident, your insurer may not be able to fully assess the scenario, resulting in claim denial.

  • Waiting Period
    In case you file a claim for the expenses of the treatment of a disease having a certain waiting period which is still not completed, your claim could be denied.

Note: Kindly refer to the policy wordings to check the complete list of policy exclusions.

How Can I Track my Aditya Birla Health Insurance Claim Status?

Raising a claim is one of the most essential parts of any health insurance plan. So, it is important that you understand everything about the process. Once you have raised your claim, you can track its progress. Follow the simple steps below to track your health insurance claim:

 

  • Visit the official website of Aditya Birla Health Insurance Company

  • On the home page click on "Claims" 

  • Choose "Check claim status" from the drop-down menu

  • Fill in the details as asked and log in

  • On successful login, you can easily track the details of your claim.

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FAQs on Aditya Birla Health Insurance Claim Settlement Ratio

  • ✔️Can I get a cashless claim facility with Aditya Birla health insurance?

    Yes, you get the cashless treatment facility with Aditya Birla health insurance, where you can get your treatment done at the nearest network hospital, without having to shell out money from your pocket.

  • ✔️What’s the first step of filing a claim?

    The very first step of filing a claim is to get in touch with the insurer and intimate the team about the planned hospitalisation or unplanned hospitalisation in case of a medical emergency.

  • ✔️How long does it take for claims to be settled?

    Each insurance company has their own claim settlement process and timelines. You should contact your insurance provider to know the exact time for claim settlement. 

  • ✔️How can I check my Aditya Birla health insurance claim status?

    You can contact the Aditya Birla Health Insurance customer support team at 1800-270-7000 to know your claim status.

  • ✔️How can I contact the Aditya Birla Health Insurance support team by email?

    You can reach out to Aditya Birla Health Insurance representatives at care.healthinsurance@adityabirlacapital.com.

  • ✔️Is it safe to buy health insurance online?

    Yes, it is completely safe to buy insurance online as long as you buy it from a trusted and reputed source.