Kotak Health Insurance Claim Settlement Ratio

Kotak General Insurance Company follows a smooth and fast claim settlement process. And to check the ability of health insurance companies to pay off the claims, it is important to check their claim ratio.  The insurer’s health claim settlement ratio is 76.20%, which is quite satisfactory. The claim settlement process is followed by the insurer is quite easy and offers convenience to the policyholders.

The insurance company offers a wide range of healthcare facilities and has settled multiple claims in a fast-paced manner. Under Kotak General Insurance policies, you can file both reimbursement and cashless claims.

Kotak Mahindra Health Insurance at a Glance:

Key Features

Highlights

Network Hospitals

4000+

Incurred Claim Ratio

48.21

Renewability

Lifelong

Waiting Period

4 years

How to Claim Kotak Health Insurance?

A health insurance claim is the request made for reimbursement of medical expenses during the policy term. The insurance company can also make direct payments to the hospital. To avail of health insurance benefits and receive payments for medical expenses the insured needs to submit a claim request. Here we have explained both cashless and reimbursement processes in detail.

Kotak Health Insurance Cashless Claim Process at Network Hospital

Check out your cashless insurance claim step-by-step:

  • Planned Hospitalization: Visit the cashless helpdesk at the hospital 48-hours before the hospitalization. Fill the pre-authorization form and submit it along with a valid photo ID and medical documents
  • Emergency Treatment: Visit the hospital’s cashless helpdesk within 24-hours. Fill the pre-authorization form and submit it along with a valid photo ID and medical documents
  • Claim Settlement:  If the claim is admissible, then the insurer will settle the bills up to the approved amount at the time of getting discharged. Simply put, you only need to pay inadmissible expenses and deductibles to the hospital at the time of discharge. If the claim is not sanctioned you can pay the bills on your own and submit the claim reimbursement request

Kotak Health Insurance Reimbursement Claim Process

Another way to file your health insurance claim is via reimbursement. You get the treatment done and pay the medical expenses upfront, and submit all the hospital bills to Kotak General Health Insurance. Upon assessment of the bills, the insurance company will reimburse the expenses you have incurred based on your sum insured limit. The procedure to file reimbursement is given below:

  • Intimate the insurer over email or call
  • Settle all the hospital bills at the time of discharge and collect all the relevant documents
  • Now submit all the original documents, and complete the claim form within 30 days  of getting discharged from the hospital
  • Post verifying all the documents  your claim will be processed within 15 days

Documents Required for Kotak Health Insurance Claims

The most important documents that are necessary for Kotak health insurance claim settlement are given below:

  • You need a valid photo ID proof
  • You also need original investigation reports
  • You also need to provide the Post-mortem report ( as required)
  • Submit all the original hospital bills/receipts
  • Further, submit the duly-filled claim form and Indoor case papers
  • The insurer will also ask for pharmacy bills and doctor’s prescription
  • Provide the treating doctor's original consultation notes and reports
  • Nature of operation performed and surgeon's bill and receipt
  • Get the Hospital Discharge report

If you need any more details on the Kotak health insurance claim settlement process then you can speak to our health insurance experts online. You can write to us at This email address is being protected from spambots. You need JavaScript enabled to view it. and call us at 1800-208-8787

FAQs

Written By: PolicyBazaar - Updated: 15 April 2021

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