Claim Settlement Ratio in the medical insurance sector allows the customers to understand how the Health Insurer will handle their claim. A consistent health claim settlement ratio is a good indicator of a company’s ability to settle the claims received.
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Care Health Insurance Company secures an impressive claim settlement ratio of 92.23% in 2019 and 89.69% in 2018. Simply put, the company received a total of 700,596 claims as of March 2019 and settled 92.3 percent of them. So, their claim settlement pattern is consistent, which makes it one of the trusted health insurance companies among the Indian Insurance customers.
|Incurred Claim Ratio ( 2018-2019)||55%|
|Claim Settlement Ratio||95%|
|Waiting Period specified for Pre-existing disease(s)||4 years|
|Policy Renewability||Lifetime renewal|
|Total Claim Paid||7lakh+|
The ideal claim settlement ratio of health insurance providers should range between 80% and 90%. The claim settlement ratio of Care Health Insurance Company for 2019 and 2018 was 92.93 % and 89.69% respectively.
So, the insurers’ health claim ratio reflects their efficiency, reliability, sound financial health, and great value products. This claim ratio is determined by using this formula:
Health claim settlement ratio= Total claims settled/ total reported claims- pending claims at the start of the year- pending claims at the end of the fiscal year
Care Health Insurance Company ensures smooth claim settlement for all its health insurance plans including family floater plans, senior citizen plans, coronavirus health plans, Arogya Sanjeevani policy, and even critical illness plans.
The policyholder can avail cashless hospitalization in more than 7900 network hospitals across 500 cities in India. Moreover, easy online payment is also possible. Mentioned below is the process for both cashless claims and reimbursement claims.
Care health insurance cashless claims can be settled without the hassle of submitting all the medical bills and discharge summary. If you have availed treatment in a network hospital then you can file a cashless claim request with the insurer by following the steps illustrated below:
If you have availed treatment in a non-network hospital then you can file a reimbursement claim request with the insurer by following the steps given below:
There is an option to download the medical insurance claim forms from the insurer’s website. However, you need to submit the following documents along with the duly filled claim form-
For any additional details you can speak to our health insurance experts and make an informed purchase.
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