Aditya Birla Health Insurance Claim Settlement Ratio

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      Aditya Birla Health Insurance Claim Settlement Ratio

      Aditya Birla Health Insurance claim settlement ratio indicates how many claims the insurance company is likely to settle in a financial year. It is calculated with the help of the following formula:

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      Claim Settlement Ratio (CSR) = (Number of claims settled/Number of claims received) * 100

      For example, if the health insurer receives 1000 claims and settles 950 claims, then the claim settlement ratio will be 95%.

      Ideally, a claim settlement ratio above 85% is considered good. Impressively, Aditya Birla Health Insurance Company has a claim settlement ratio of 93.7% in FY 2021-22.

      Claim Process of Aditya Birla Health Insurance

      Aditya Birla Health Insurance Co. accepts both cashless and reimbursement claim requests. You can avail cashless treatment at any of the network hospitals of the insurance company, but for treatments availed at non-network hospitals, you can raise a reimbursement claim. The claim process for Aditya Birla health insurance plans is given below:

      Claim Process for Cashless Treatment:

      Steps to raise cashless claims under Aditya Birla health insurance plans are given below:

      1. Get admitted to a network hospital of your insurance company to avail cashless claim facility.
      2. Notify Aditya Birla Health Insurance Company about your emergency hospitalization within 48 hours and planned hospitalization at least 3 days prior.
      3. Show your health insurance cashless card and provide your health insurance policy number. For identification purposes, you can show valid ID proof like your PAN card, passport, voter’s ID, etc.
      4. Post identification, fill up the cashless pre-authorization form and submit it to the network hospital. The hospital will submit the filled-in pre-authorization or cashless form to the insurer. 
      5. The insurer will review the details and notify the decision to the network hospital. You will receive intimation within 2 business hours. You can also check your claim status online.
      6. If approved, the insurer will process the claim and pay the bill amount to the hospital after you are discharged.

      Claim Process for Reimbursement Treatment:

      The process for reimbursement claims is as follows:

      1. Notify the insurer within 48 hours of an emergency hospitalization. If the treatment or surgery is pre-planned, then notify the insurer at least 3 days beforehand.
      2. Avail treatment and pay all the medical bills at the time of hospital discharge.
      3. Submit all the required documents from the hospital, including the duly filled reimbursement claim form.
      4. All the documents, proofs, and papers will be reviewed by the insurer and the decision will be taken accordingly. You will get an intimation over a call or email.
      5. Once the request is approved, the claim amount will be reimbursed.

      Documents Required for Aditya Birla Health Insurance Claim Settlement

      The documents required for Aditya Birla medical insurance claims are given below:

      • Duly filled out Aditya Birla health insurance claim form
      • Policy copy/Health card
      • KYC documents, i.e. address proof, age proof, and photo ID
      • Copy of hospital registration Certificate
      • Discharge summary
      • Hospital bills/receipts/break-ups
      • Invoice/Implant stickers
      • Consultation papers
      • Original prescriptions/pharmacy bills
      • Doctor’s letter describing the insured’s medical condition and suggested treatment
      • Original diagnostic reports
      • Copy of FIR in case of accidents

      To know more details, you can get in touch with the customer care team at Policybazaar on the helpline number- 1800-208-8787.

      Policybazaar exclusive benefits
      • 30 minutes claim support*(In 120+ cities)
      • Relationship manager For every customer
      • 24*7 claims assistance In 30 mins. guaranteed*
      • Instant policy issuance No medical tests*
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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

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