Cholamandalam Health Insurance Claim Settlement Ratio

Cholamandalam Health Insurance Claim Settlement Ratio

The health claim settlement ratio is an important factor in health insurance. It gives an understanding to the customers regarding the insurer’s ability to handle their claim requests. A higher health claim settlement ratio reflects positively on the insurer’s likelihood to settle customers’ claim requests. The claim ratio for all the health insurance companies varies from each other.

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Cholamandalam MS General Insurance Company enjoys a claim settlement ratio of 95% for the FY 2018-2019. So, their claim settlement record shows that 95% of the claim requests were paid by the insurer. If you have any of the Cholamandalam MS health insurance plans and want to file a claim, then here is what you need to know about the claim documents, cashless, and reimbursement procedures.

Cholamandalam Health Insurance at a Glance:

Claim Process for Cholamandalam Health Insurance Plans

The cashless and reimbursement claim procedures for planned and emergency hospitalization by Cholamandalam MS General Insurance Company are given below:

Cholamandalam Cashless Claim Procedure for Planned Hospital Admission:

• When a network hospital is selected, you should inform the insurance company at least 48 hours before getting admitted to the hospital by either calling customer care or filling out the claim form on the website.
• Inform the network hospital about your Cholamandalam health insurance policy before getting admitted. Carry your policy copy and photo id with you.
• Fill up the pre-authorization form with the help of your doctor. The hospital should share the form with the Cholamandalam MS General Insurance Company within 24 hours of admission.
• The insurer will review the claim request and give pre-authorization within 2 hours if the claim is approved. The insurer may also seek more information from the hospital.
• Once you have received the treatment, the hospital will share discharge documents and hospital bills with the insurance company.
• The Cholamandalam MS General Insurance Company will verify the documents and pay the claim amount within 2 hours.

Cholamandalam Cashless Claim Procedures for Emergency Hospital Admission:

• In case of an emergency, you can get in touch with any of the network hospitals within 24 hours of getting admitted.
• Furnish your policy copy and a government-issued photo ID proof, such as an Aadhar card, driving license, etc.
• The hospital will send the pre-authorization t form to the insurance company for approval.
• The insurer will review and send pre-authorization within 2 hours. The hospital will be intimated in case any additional information is required.
• After your discharge, the hospital will send your medical bills and discharge documents to the insurer.
• The insurance company will settle the claim within 2 hours.

Cholamandalam Reimbursement Claim Procedure:

• In case you are admitted to a non-network hospital, you must inform the insurer within 48 hours of admission.
• Avail the treatment and pay all the medical bills directly at the hospital during discharge.
• Scan and upload all relevant claim documents after self-attesting within 30 days of getting discharged from the hospital.
• The insurer will review all the documents and give approval within 7 working days.
• The claim amount will be paid through NEFT by Cholamandalam MS General Insurance.

Documents Required for Cholamandalam Health Insurance Claims

Here is a list of documents that you need to submit at the time of a Cholamandalam health insurance claim settlement:

• Claim form filled and signed by you
• Discharge summary/card issued by the hospital
• Doctor’s prescription for hospitalization
• All the medical reports/bills/documents
• Receipts of all the payments made
• Medicine bills with prescriptions
• Additional documents as required

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