Reliance Health Insurance Claim Settlement Ratio

Reliance Health Insurance Claim Settlement Ratio

Reliance General health insurance claim settlement ratio has been consistently good over the years, which makes it a great choice to buy health insurance online. The Claim Settlement Ratio (CSR) refers to the number of claims settled by the insurer as compared to the total number of claims received in a fiscal year. Generally, a CSR of more than 85% is considered ideal.

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In FY 2021-22, the Reliance health insurance claim settlement ratio is 95.3%, showcasing that the insurer is trustworthy and can quickly settle all your claim requests. Moreover, the round-the-clock accessibility to insurer claim support is an added advantage.

Claim Process of Reliance Health Insurance

Reliance health insurance policyholders can either raise a cashless claim or a reimbursement claim. While lodging a claim with Reliance General Insurance Company, make sure that you have the following details handy:

• Reliance medical insurance policy number
• Contact details of the policyholder (contact no., email id, address, etc.)
• Name of the person who is admitted to the hospital
• Relationship with the hospitalized person
• Hospital name
• Nature of the disease and the date of commencement of the symptoms
• Nature of the accident, if applicable
• Time, date, and location of the accident

Reliance Health Insurance Cashless Claim Procedure:

The process to claim cashless treatment expenses under Reliance health insurance plans is as follows-

• Take admission in any of the Reliance General Insurance Company’s empanelled hospitals
• Intimate the insurer about your hospital admission at least 2 days before a planned hospitalization and within 24 hours of an emergency hospitalization
• Present your Reliance health card at the Third Party Administrator (TPA) helpdesk of the hospital
• Submit the duly filled cashless request form to the TPA desk
• The hospital will share your cashless request form with the RCare Health team, and you will get approval after review.
• Sign all the bills at the hospital during discharge
• The hospital will send the bill to the insurer, and the bill amount will be paid.

In case your cashless claim is rejected by the insurer, you must pay the bills from your own pocket while getting discharged from the hospital. Make sure to collect all the reports, bills, and other documents from the hospital and file a reimbursement claim with the Reliance General Insurance Company.

Reliance Health Insurance Reimbursement Claim Process:

• Inform the insurance company about your planned hospitalization at least 2 days prior and emergency hospitalization within 24 hours
• Get treatment at the hospital and pay all the hospital bills
• At the time of discharge, collect all the reports, bills, and documents (in original)
• Submit all the supporting documents to the insurance company within 15 days of hospital discharge
• The insurer will verify your documents and accordingly, pay you the claim amount.

Documents Required for Reliance General Health Insurance Claim

Here is a checklist of the documents that you need to submit while filing a claim for Reliance health insurance plans:

Daycare Treatment/Hospitalization:

• Claim form filled and duly signed by you
• Doctor’s prescription stating the onset of the symptoms
• Medical treatment papers
• Diagnostic reports (like ECG, X-ray, etc.)
• Original receipts and medical bills
• Ambulance bill/receipt
• Discharge card from the hospital (original)
• In accidental cases, a copy of the FIR is required
• Cancelled cheque
• A copy of the Reliance Health card
• Xerox copy of PAN card/ID card

Domiciliary Hospitalization:

• Reliance medical insurance claim form ( duly filled & signed)
• The first prescription from the doctor (stating the date of the onset of the symptoms of the illness)
• Doctor’s prescription and healthcare treatment papers
• Medical investigation reports
• Receipts and original medical bills
• FIR report (in case of an accident)
• Certificate from the medical practitioner recommending the treatment at home
• Documents proof showing lack of accommodation in the nursing home/hospital
• ID card
• A cancelled cheque

Critical Illness Claims:

• Claim form
• Doctor’s certificate with the diagnosis of the illness (stating the initial symptoms)
• Radiology reports, pathology reports, and other investigation reports
• Original receipts and hospital bills
• Chemist bills
• Hospital admission and discharge card/ certificate
• Cancelled cheque/1st page of passbook
• Identification card

To know more about health claims, you can call our helpline number at 1800-208-8787. You can also email us at care@policybazaar.com.