Cholamandalam Health Insurance Claim Settlement Ratio

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      Cholamandalam Health Insurance Claim Settlement Ratio

      Cholamandalam health insurance claim settlement ratio is important to understand the insurer’s ability to handle the claim requests of the customers. A higher claim settlement ratio reflects positively on the insurer, indicating the likelihood of settling most customers’ claim requests. Generally, a claim settlement ratio above 85% is considered ideal.

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      The Cholamandalam MS General Insurance Company enjoys a claim settlement ratio of 87.5% for FY 2021-2022. This indicates that 87.5% of the claim requests received by the insurer were paid. It also helps to make the insurance company a preferred choice for buying health insurance.

      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.
      • Carry your policy copy and photo ID with you while getting admitted to the hospital.
      • Fill up the pre-authorization form and submit it at the hospital. The network hospital will share the form with the Cholamandalam MS General Insurance Company.
      • The insurer will review the claim request and give pre-authorization for cashless treatment 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.

      Cholamandalam Cashless Claim Procedures for Emergency Hospital Admission:

      • In case of an emergency hospitalization, you must inform the insurer 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., at the hospital.
      • Fill out the pre-authorization form so that the hospital can send it to the insurance company for cashless treatment 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 verify the documents and pay the claim amount.

      Cholamandalam Reimbursement Claim Procedure:

      • You must inform the insurer about your planned hospitalization at least 48 hours in advance and about emergency hospitalization within 24 hours of admission.
      • Avail the treatment and pay all the medical bills directly at the hospital during discharge.
      • Submit all relevant claim documents after self-attesting to the nearest branch of the insurer within 30 days of getting discharged from the hospital.
      • The insurer will review all the documents, give approval and pay the claim amount through NEFT by Cholamandalam MS General Insurance Company.

      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 reimbursement claim settlement:

      • Claim form filled and signed by you
      • Discharge summary/card issued by the hospital
      • Doctor’s prescription advising hospitalization
      • Final hospital bill and payment receipts in original
      • All the medical investigation reports/
      • Cancelled cheque from policyholder’s bank account
      • Medicine bills with prescriptions
      • CYKYC
      • Invoices or stickers for implants
      • FIR or Medico Legal Certificate (MLC) in case of road traffic accidents
      • Additional documents as required
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