Aditya Birla Health Insurance Claim Settlement Ratio

(45 Reviews)
Insurer Highlights

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Get insured from the comfort of your home
Get insured from the comfort of your home
  • 1
  • 2
  • 3
  • 4

Who would you like to insure?

  • Previous step
    By clicking on “Continue”, you agree to our Privacy Policy and Terms of use
    Previous step

      Popular Cities

      Previous step
      Previous step

      Do you have an existing illness or medical history?

      This helps us find plans that cover your condition and avoid claim rejection

      Get updates on WhatsApp

      What is your existing illness?

      Select all that apply

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step
      Advantages of
      entering a valid number
      You save time, money and effort,
      Our experts will help you choose the right plan in less than 20 minutes & save you upto 80% on your premium

      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:

      Read More

      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*
      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

      Health insurance articles

      Recent Articles
      Popular Articles
      10 Reasons Why Your Health Insurance Claim Can Get Rejected

      01 Dec 2023

      Health insurance plans add a layer of invisible protection against
      Read more
      Knee Replacement Surgery Cost in India

      30 Nov 2023

      Knee pain has become a very common ailment in India, with over 15
      Read more
      Kidney Transplant Cost in India

      30 Nov 2023

      Kidney disease has been growing at an alarming rate in India. As
      Read more
      How Can NRIs Save Taxes on Health Insurance in India?

      24 Nov 2023

      Health insurance is an essential buy for people in India as well
      Read more
      Is LASIK Surgery Covered by HDFC ERGO Health Insurance?

      21 Nov 2023

      The growing dependence on electronic gadgets has impacted
      Read more
      How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
      Ayushman Bharat Yojana is a flagship health insurance scheme launched by the Government of India to offer universal
      Read more
      Best Health Insurance Plans for Senior Citizens in 2023
      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance
      Read more
      10 Major Benefits of Ayushman Bharat Yojana
      Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the second component under Ayushman Bharat Scheme. PM Narendra Modi
      Read more
      Does Health Insurance Provide Coverage for LASIK Eye Surgery?
      A vast majority of the Indian population is suffering from vision problems. For some of them, LASIK eye surgery is
      Read more
      Pre-Existing Disease (PED) Cover from Day One
      Pre-existing diseases (PED) are mostly expensive to treat as they are chronic in nature. Unfortunately, most health
      Read more

      Download the Policybazaar app
      to manage all your insurance needs.