Cholamandalam Health Insurance Claim Settlement Ratio

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 consistent health claim ratio is reflects positively on the insurer’s ability to settle customer’s claim requests. The claim ratio for all the health insurance companies varies and is given by IRDAI in their annual circular.

Chola MS General Insurance Company is 50.01% for the FY 2018-2019. So, their claim settlement record shows that 50% of the claim requests were paid by the insurer. If you have any of the Chola 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:

Key Features

Highlights

Network Hospitals

8000+

Incurred Claim Ratio

39.96

Renewability

Lifelong

Waiting Period

4 years

Claim Process for Cholamandalam Health Insurance Plans

The procedure for planned and emergency hospitalization in both cashless and reimbursement procedures are given below:

Cholamandalam Cashless Procedures for Planned Hospital Admission

When a hospital is selected the policyholder should approach to them 48 hours in advance and provide all the policy details/ e-cards along with a Government issued photo ID proof like Aadhaar Card/ Driver’s License the Insurer’s Third-Party Administrator (TPA) desk. Furthermore:

  • Once the claim is validated by the treating hospital and the pre-authorization request is sent to the Chola MS General Insurance Company
  • The insurer shall review the claim request, confirm and approve the health claims as per the policy terms and conditions
  • The insurance company will inform you and the hospital in case any additional information related to the treatment or documents are required
  • Chola MS General Insurance Company will settle the claims at the hospital

Cashless Procedures for Emergency Hospital Admission

In case of emergency hospitalization, you can get in touch with any of the Network Hospitals within 48 hours of hospitalization

  • Furnish your health card and a Government issued ID proof such as Aadhar Card/Driving License
  • If you need more assistance you can email us at This email address is being protected from spambots. You need JavaScript enabled to view it. or call us or chat with us online and we will help you with your claims
  • After this the hospital validates the claim requests and sends a pre-authorization request form to the Insurance Company
  • The insurer shall review, confirm and approve the claim as per policy terms and conditions
  • The hospital and the insured will be intimated in case any additional information is required
  • Chola MS will then settle the claim with the hospital

Future Generali Reimbursement Claim Procedure

In case of hospitalization you can inform the insurer within 48 hours of admission at any of the Network or non-Network Hospitals.

  • You can pay the bills directly at the hospital once you get admitted
  • You can submit all the relevant claim documents and the claim form
  • The insurer will review the request, and will give approval as per the policy terms and conditions
  • The claim shall be settled by Chola MS General Insurance to the insured

Documents Required for Cholamandalam Health Insurance Claims

Here is a list of documents that you need to carry at the time of 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

FAQs

Written By: PolicyBazaar - Updated: 15 April 2021
Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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