Iffco Tokio Health Insurance Claim Settlement Ratio

In FY 2019, Iffco Tokio General Insurance settled nearly 8.61 lakh claims and has a health claim settlement ratio of 92.65%. The insurer is a pioneer in the health insurance sector and is dedicated to providing hassle-free settlement of health insurance claims. While selecting a health insurance plan a lot of people forget to check the insurer’s claim ratio. But this is one of the most important parameters in deciding the right health insurance policy online.

IFFCO Tokio Health Insurance Policies at a Glance

IIFCO Tokio Health Insurance Sum Assured Entry Age Critical Illness Coverage and Benefits
Swasthya Kavach Family Health Insurance 2 to 5 Lakhs No Limit NA
  • Ambulance charges
  • Daily Cash allowance
  • Domiciliary hospitalisation expenses
  • Pre-hospitalisation expenses up to 30 days
  • Post-hospitalisation expenses up to 30 days.
  • Organ donor expenses
Individual Medishield Policy 1 to 5 Lakhs 3 months to 80 years NA
  • Organ donors hospitalisation expenses
  • Ambulance charges:
  • Cash benefits.
  • Pre/Post-hospitalisation expenses up to 45 days/60 days
Critical Illness Insurance Policy NA No Limit It provides coverage only for critical illness
  • Cancer
  • Renal failure
  • Coronary artery diseases for which bypass surgery is required.
  • Major organ transplant
  • Paralytic Cerebral Stroke
  • Loss of limbs due to accidents
Family Health Protector Policy Up to 7 Lakhs Entry age is 0 and there is no maximum limit NA
  • Doctor consultation fees
  • Organ donor expenses
  • Ambulance charges
  • Cashless hospitalization
  • Domiciliary treatment expenses
  • Pre and post hospitalization expenses
Health Protector Policy More than 5 Lakhs No Limit Covers more than 10 critical illnesses
  • Organ donors hospitalisation expenses
  • Ambulance charges
  • Cash benefits
  • Pre/Post-hospitalisation expenses up to 45 days/60 days respectively
IFFCO Tokio Personal Accident Insurance Policy NA 5 years to 70 years NA
  • Ambulance charges
  • Organ donor expenses
  • Cashless hospitalization expenses

Claim Process of Iffco Tokio Health Insurance

Looking at the health claim ratio of the Iffco Tokio General Insurance Company you can be sure that the insurer will settle your claim timely. While there are two ways i.e. reimbursement and cashless claim process to settle health insurance claims in India, check out how you can register your claim to get the coverage amount in case of a health emergency.

Claim Process for Cashless Treatment:

To avail cashless hospitalization the process is described below-

  • Intimate the insurance provider 3-days in advance for planned hospitalization.
  • For unplanned hospitalization, you need to inform the insurer as soon as possible on their toll-free customer care number and via email
  • You need to provide your health card and ID proof at the hospital desk. After verifying the personal details, the hospital authorities will submit a duly-filled form along with a signed pre-authorization request form to the insurance company’s TPA
  • After verifying the same, the hospital will allow the cashless treatment as soon as the approval is received from the TPA (Third-Party Administrator, which looks after insurance claims)
  • After submission of all the required documents, the proposer will receive approval to proceed with cashless hospitalization
  • Only applicable in network hospitals

Claim Process for Reimbursement Treatment

To get reimbursement of hospitalization claims the process is described below-

  • This is applicable in non-network hospitals or on disapproval of cashless claims.  The insured person will need to submit the medical bills, and will also require to claim for reimbursement within 7 days from the discharge date.
  • You need to submit the duly filled reimbursement claim form along with other required documents at the closest IFFCO Tokio branch. 
  • Soon after verification, the assured claim amount will be reimbursed by a cheque to the proposer. This shall be done within 20 days from the date of receipt of all the required documents.

Documents Required for Iffco Tokio Health Insurance Claims

Submit the following documents while filing a claim for your Iffco Tokio health insurance policy:

  • Claim form that is duly signed and filled. Either you can download it or get it from the insurer’s office
  • All the bills, memos, receipts to claim the amount
  • Survey report
  • Hospital files, medical certificate, and other related documents signed by the doctor
  • Cash memo for medicines that have been purchased from an external pharmacy.
  • Discharge card from the hospital
  • Summary report 
  • Clearance documents
  • FIR report is required in case the hospitalization was done due to an accident 

To have a better understanding you can get in touch with our health experts at Policybazaar on 1800-208-8787

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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