Care Health Insurance Claim Settlement Ratio

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      Care Health Insurance Claim Settlement Ratio

      Care Health Insurance claim settlement ratio allows customers to understand if the insurer will settle their claims. A Claim Settlement Ratio (CSR) is a good indicator of a company’s claim efficiency, reliability, and sound financial health. Generally, a CSR above 85% is considered good. It can be determined by using this formula:

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      Claim Settlement Ratio= (Total claims settled/ total reported claims) X 100

      Care Health Insurance has secured an impressive claim settlement ratio of 87.1% in FY 2021-22. This shows that the insurer has a consistent claim settlement pattern and is likely to settle the claims raised by most policyholders. Moreover, Care Health Insurance offers 24x7 claim and customer support.

      Claim Process of Care Health Insurance

      Care Health Insurance Company ensures smooth settlement of cashless as well as reimbursement claims. Mentioned below is the process for filing both cashless claims and reimbursement claims:

      Claim Process for Cashless Treatment:

      If you have availed treatment in a network hospital, then you can file a cashless claim request with Care Health Insurance by following the steps given below:

      • Claim Intimation: You can inform the customer care team at least 48 hours before a planned hospitalization and within 24 hours of an emergency hospitalization.
      • Initiate Pre-authorization Process: Now submit the filled-in pre-authorization form at the hospital’s insurance desk. The hospital will send the form to the insurer and seek cashless treatment approval.
      • Processing of Pre-authorization Request: The in-house claim management team will review the request and accept or reject it.
      • Claim Settlement: After your discharge, the insurer’s claim management team will pay the claim amount to the network hospital.

      Claim Process for Reimbursement Treatment:

      You can file a reimbursement claim with Care Health Insurance by following the steps given below:

      • Claim Intimation: Inform the customer support team of the insurer within 24 hours of an emergency hospitalization and at least 48 hours before a planned hospitalization.
      • Hospital Bills Payment: While getting discharged from the hospital, pay all the hospital bills and take all the documents home.
      • Initiate Claim Process: The health insurance claim form needs to be submitted along with all the required documents to the insurance company.
      • Claim Processing: All the documents will be reviewed by the claims management team of the insurer, and they will either accept or reject the claim. If the claim is rejected, a valid reason will be provided.
      • Claims Payment: If the claim is accepted, the insurer will pay the claim amount to you.

      Documents Required for Care Health Insurance Claims

      The following documents need to be submitted at the time of filing a Care health insurance reimbursement claim:

      • Duly filled and signed claim form (original copy)
      • Photo ID proof 
      • Doctor’s prescription recommending hospitalization
      • Letter from the doctor mentioning the list of medical tests, consultations, and medications
      • Receipts and bills (original copies)
      • Chemist bills (original copies) 
      • All the medical tests and reports with receipts (original copies)
      • Indoor case papers
      • Discharge card from the doctor/ hospital
      • Police FIR Report (if applicable)
      • Original post-mortem report ( if applicable)

      For additional details, you can speak to Care Health Insurance’s customer support team or the experts at

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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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