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When looking to buy a health insurance plan, one of the most important factors you need to look into 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.
Before we look at Aditya Birla health insurance claim settlement ratio, let’s take a minute to understand what claim settlement ratio is:
The claim settlement ratio refers to the total percentage of insurance claims that an insurance provider settles relative to the total number of claims received in a given period. The higher the claim settlement ratio of an insurance company, the higher are the chances that your claim will be approved. Here is the formula for claim settlement ratio:
Claim Settlement Ratio = (No of claims settled/No. of claims received)x100
Aditya Birla Claim Settlement Ratio:
With an impressive claim settlement ratio of 94%, Aditya Birla Health Insurance is one of the most reliable insurance providers in the business.
Filing claims was never so simple. Just follow these steps and you’re done!
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.
Ever stuck in a medical emergency and were low on cash? Such an uncertain health emergency can drill a hole in your pocket, where you are required to spend your savings on hospital bills! 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. Aditya Birla Health Insurance plans are no different. With a cashless treatment facility available at its wide network of 6500+ hospitals, you need not worry about those hefty hospital bills!
Aditya Birla Health Insurance has simple procedures that enable a hassle-free claim process. All you need to do is:
In case of planned hospitalization, inform your insurer at least 1-2 days in advance and in case of an emergency, notify within 24 hours
Submit the required documents like health card, identity card and medical report
Your insurance company verifies the details against your health insurance policy coverage and terms
If your claim request is within the coverage, approval is sent to the hospital for the specified amount.
Take care of the following documents when filing a cashless claim with Aditya Birla Health Insurance:
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 the patient is discharged, the insurance company reimburses the policyholder/insured of their 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, reimbursement claims can be filed for treatments done in non-network hospitals as well, a feature not available when opting for cashless claims settlement.
Inform your insurance provider about the hospitalisation of the insured and intent to file a reimbursement claim.
After the necessary medical treatment, submit the documents like claim form, discharge summary, medical bills, and OPD expense bills with your insurance company.
After verification documents against the claim, your insurance provider will either accept or deny your claim request
If the claim is approved, the said amount is disbursed
Take care of the following documents when filing a cashless claim with Aditya Birla Health Insurance:
Here are some reasons why your claims on your health insurance policy may get rejected:
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
In case you file a claim for an incident that is excluded from your health insurance policy, your claim may get rejected
In case you file a claim after your policy is lapsed, your claim would be denied
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
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 policy wordings to check complete list of policy exclusions.
At Finserv MARKETS, we are committed to serve you better. Here’s how you can connect with us, should you need any help with Aditya Birla Health Insurance!
Aditya Birla Health Insurance team is dedicated to providing complete customer support, when it comes to managing queries and offering assistance regarding products, claim process, renewal, or more.
Yes, you get 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.
The very step of filing a claim is to get in touch with the insurer and intimate the team about the planned hospitalization or unplanned hospitalization in case of a medical emergency.
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.
You can reach out to Aditya Birla Health Insurance representatives on care.healthinsurance@adityabirlacapital.com.
Yes, it is completely safe to buy insurance online as long as you buy it from a trusted and reputable source.