Bharti AXA Health Insurance Claim Settlement Ratio

It is imperative to check the Health Claim Settlement Ratio of an insurance company from where you are buying a health insurance policy. Talking about Bharti AXA General Insurance Company the insurer has a claim ratio of above 90%, which is quite good. Any health claim ratio above 85% is super reliable and can ensure timely settlement. You can read to know more about the Bharti AXA General health insurance claim settlement procedure.

 

Bharti AXA Health Insurance at a Glance

Features

Specifications

Network Hospitals

4500+

Incurred Claims Ratio ( as per the IRDAI 2018-19 Report)

89%

No. of Claims Settled 

18 lakh+

Number of Policies Issues

1.3 million

Renewability

Lifelong

Bharti AXA Health Insurance Claim Process

Bharti AXA health insurance claims are handled in the most smooth and secured manner. The claim settlement process is transparent and requires limited intervention. To file for both cashless and reimbursement of your medical treatment cost you can follow the procedure as given below.

Cashless Claim Settlement Process

If you are covered under a Bharti AXA health insurance plan then you can avail cashless treatment in nearly 4500+ network hospitals. Once you get admitted into the hospital for an emergency or a planned procedure then you need to tell the treating doctor to fill a preauthorization request form.

The insurer will take action within 6 hours of getting all the documents for emergency hospitalization, or 48 hours for planned hospitalization.

Also, you will receive the authorization for emergency treatment within 6 hours of receiving the form and within 48 hours of receiving the form in case of a planned medical procedure. And if you do not get approval for cashless claims, that doesn’t mean that your application won’t be settled. Bharti AXA General Insurance Company examines the claims on individual merit and will reimburse the amount if the claim request is accepted.

You are not required to pay anything to the hospital after receiving the authorization letter, except under the following circumstances:

  • If the total hospital bill amount is more than the sum insured or coverage amount
  • There is a percentage of deductibles or Excess that needs to be borne by you
  • There are some unrelated treatment or non-medical expenses
  • Also, if the amount approved by the insurer is lesser than the actual bill amount

Reimbursement Claim Settlement Process

For healthcare treatment in a non-network or non-registered hospital, the procedure starts by informing the Insurance Company within 7 days of getting hospitalized. Bharti AXA claim procedure for reimbursement is given below:

  • On completion of the health treatment, you need to collect all your invoices, hospital bills, reports, etc.
  • And after you get discharged from the hospital you get all the prescriptions from the doctor, medical bills, treatment details, discharge summary, pharmacy bills, etc.
  • Further, you can submit your pre and post hospitalization expenses within 15 days of the last day of the post-hospitalization duration as mentioned in the policy
  • After submission of all the document Bharti AXA General Insurance will settle your claims within 30-days
  • If the treatment cost is covered in the policy, then the insurer will settle your bills within 21 days of receiving all the documents
  • However, if the insurer rejects your claim then the same will be communicated to you 

Documents Required for Bharti AXA Health Insurance 

  • Claim form to be duly signed by the policyholder and the concerned doctor
  • Discharge summary (original)
  • Original receipts, bills with a detailed break-up of the costs
  • Doctor’s prescription, consultation report, and lab reports 
  • In case of medical history, a letter/statement from the treating doctor is required
  • In case of an accident ( a letter from the treating doctor and Police FIR copy is required)
  • In case of an accident, a police FIR copy and a letter from the treating doctor related to intoxication and any other condition is required
  • In case  of a non-network hospital  registration certificate of the hospital is required
  • In case of delay in claims, a letter from the policyholder stating the reason for the delay is required 
  • Health ID card/ copy of Bharti AXA health insurancepolicy/ TPA ID Card, along with address and ID proof of the proposer and patient is required
  • A cancelled cheque ( as the case may be) 

Once the documents are reviewed, you will receive your payment within 21 days of the submission of the documents. If the medical condition is not covered under Bharti AXA mediclaim policy, you will receive a letter mentioning the reason for rejection. For more details please speak to our customer care team or chat

Written By: PolicyBazaar - Updated: 15 April 2021

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