Raheja QBE Health Insurance Claim Settlement Ratio

Raheja QBE health claim settlement ratio is a parameter to scale the percentage of health insurance claims a health insurance provider has settled during a financial year. The claim ratio is derived with the simple formula that calculates the number of claims received and the number of claims that have got settled and also the pending claims from the previous year. Before you buy the policy make sure that you check the health claim ratio as well, as it is a good indicator of how many claims request the insurer can settle during the policy term.

Raheja QBE Health Insurance at a Glance:

Key Features

Highlights

Network Hospitals

2000+

Incurred Claim Ratio

18.19

Renewability

Lifelong

Waiting Period

-

How to Claim Raheja QBE Health Insurance?

Raheja QBE health insurance claim process is simple and smooth. If you need clarity as to how to file a health insurance claim with Raheja QBE General Insurance Company then here is what you need to do. We have explained the claim procedure for both cashless and reimbursement treatment along with the documents that need to be submitted.

Raheja QBE Cashless Claim Procedure:

Read this step-by-step guide if you want to know about Raheja QBE cashless claim procedures:

  • Firstly avail the cashless hospitalization service at the nearby Raheja QBE network hospitals
  • To start with the claim process fill and submit the pre-authorization form and get it signed by the attending doctor and the policyholder
  • Do not forget to mention your contact number on the Raheja QBE pre-authorization form
  • If you are going for a planned hospitalization, then Kotak General Insurance requires you to submit the pre-authorization form within 15 days of hospital admission
  • For emergency treatment, you need to send the pre-authorization form within 24 hours of hospitalization
  • In case the insurer denies cashless claims,  you ( the insured) needs to meet the cost of treatment and later the insurance company will reimburse those expenses for you
  • For any future reference you can quote your cashless (pre-authorization) number to RQBE
  • Any enhancement request needs to be made only after getting discharged from the hospital
  • You( the policyholder) to bear all the co-payments, inadmissible expenses, or deductions

Raheja QBE Reimbursement Procedure:

To proceed with Raheja QBE reimbursement claims follow the process as given below:

  • You need to mention your address details on the Raheja QBE mediclaim form
  • It is going to help you if you have a photocopy of the claim documents with you
  • When you submit the claim form make sure that it is filled and signed by your doctor and you both
  • Your mobile number should be mentioned on your claim form
  • Submit all the claim documents in original within 30 days of getting discharged from the hospital
  • For any future reference you can use your claim reference number
  • You ( the policyholder) to bear all the co-payments, inadmissible expenses, or deductions

What are the Documents Required for Raheja QBE Health Insurance Claims?

If you want your claim request to be processed fast these are the documents that you need to submit to the insurer:

  • Duly filled claim form duly signed by the insured and the treating doctor
  • Discharge summary from the hospital with the details of the treatment, doctor’s consultation papers, hospital bills with break-up along with interim bills payment receipts
  • At the time of claim, you also need to provide investigation reports like X-ray, original blood report, CT Scans, sonography, MRIs, etc.
  • A photocopy of your health card along with other medical documents is required
  • All the pharmacy bills with doctor’s prescriptions
  • Do submit if you have got invoices of the Implant sticker, stent details in angioplasty, lens details in cataract case, miscellaneous charges, etc.
  • An FIR report is a must for all the accidental cases
  • All the medical documents related to the treatment needs to be submitted in original to the TPA
  • Death certificate/ Post-mortem report
  • Inquest/Panchanama Report
  • Coroner’s Report
  • Submit the documents at the nearest Raheja QBE branch

Raheja QBE health claim settlement ratio is a parameter to scale the percentage of health insurance claims a health insurance provider has settled during a financial year. The claim ratio is derived with the simple formula that calculates the number of claims received and the number of claims that have got settled and also the pending claims from the previous year. Before you buy the policy make sure that you check the health claim ratio as well, as it is a good indicator of how many claims request the insurer can settle during the policy term.

How to Claim Raheja QBE Health Insurance?

Raheja QBE health insurance claim process is simple and smooth. If you need clarity as to how to file a health insurance claim with Raheja QBE General Insurance Company then here is what you need to do. We have explained the claim procedure for both cashless and reimbursement treatment along with the documents that need to be submitted.

Raheja QBE Cashless Claim Procedure:

Read this step-by-step guide if you want to know about Raheja QBE cashless claim procedures:

  • Firstly avail the cashless hospitalization service at the nearby Raheja QBE network hospitals
  • To start with the claim process fill and submit the pre-authorization form and get it signed by the attending doctor and the policyholder
  • Do not forget to mention your contact number on the Raheja QBE pre-authorization form
  • If you are going for a planned hospitalization, then Kotak General Insurance requires you to submit the pre-authorization form within 15 days of hospital admission
  • For emergency treatment, you need to send the pre-authorization form within 24 hours of hospitalization
  • In case the insurer denies cashless claims,  you ( the insured) needs to meet the cost of treatment and later the insurance company will reimburse those expenses for you
  • For any future reference you can quote your cashless (pre-authorization) number to RQBE
  • Any enhancement request needs to be made only after getting discharged from the hospital
  • You( the policyholder) to bear all the co-payments, inadmissible expenses, or deductions

Raheja QBE Reimbursement Procedure:

To proceed with Raheja QBE reimbursement claims follow the process as given below:

  • You need to mention your address details on the Raheja QBE mediclaim form
  • It is going to help you if you have a photocopy of the claim documents with you
  • When you submit the claim form make sure that it is filled and signed by your doctor and you both
  • Your mobile number should be mentioned on your claim form
  • Submit all the claim documents in original within 30 days of getting discharged from the hospital
  • For any future reference you can use your claim reference number
  • You ( the policyholder) to bear all the co-payments, inadmissible expenses, or deductions

What are the Documents Required for Raheja QBE Health Insurance Claims?

If you want your claim request to be processed fast these are the documents that you need to submit to the insurer:

  • Duly filled claim form duly signed by the insured and the treating doctor
  • Discharge summary from the hospital with the details of the treatment, doctor’s consultation papers, hospital bills with break-up along with interim bills payment receipts
  • At the time of claim, you also need to provide investigation reports like X-ray, original blood report, CT Scans, sonography, MRIs, etc.
  • A photocopy of your health card along with other medical documents is required
  • All the pharmacy bills with doctor’s prescriptions
  • Do submit if you have got invoices of the Implant sticker, stent details in angioplasty, lens details in cataract case, miscellaneous charges, etc.
  • An FIR report is a must for all the accidental cases
  • All the medical documents related to the treatment needs to be submitted in original to the TPA
  • Death certificate/ Post-mortem report
  • Inquest/Panchanama Report
  • Coroner’s Report
  • Submit the documents at the nearest Raheja QBE branch

FAQs

Written By: PolicyBazaar - Updated: 15 April 2021

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