Royal Sundaram Health Insurance Claim Settlement Ratio

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      Royal Sundaram Health Insurance Claim Settlement Ratio

      Royal Sundaram Health Insurance claim settlement ratio refers to the number of claims that the insurance company has paid as compared to the total number of claims filed during the financial year. A higher claim ratio indicates positively on the insurance company’s ability to settle the claim requests received.

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      Generally, any claim ratio above 85% is considered good. In FY 2021-22, the Royal Sundaram General Insurance Company earned a claim settlement ratio of 92.7%. This CSR implies that the insurer settled 92.7% of the total claims received in the financial year, thereby making it a preferred insurer to buy health insurance.

      Royal Sundaram Health Insurance Claim Process

      There are two ways to file a claim with Royal Sundaram health insurance plans:

      • Cashless Claims
      • Reimbursement Claims

      Claim Process for Cashless Treatment:

      To avail cashless claims, the treatment must be availed at a network hospital of Royal Sundaram General Insurance Company. You can check the list of network hospitals online. To raise a Royal Sundaram health insurance cashless claim, follow the steps given below:

      • If it is a planned hospitalization, you must intimate the TPA at least 72 hours before getting admitted. For emergency hospitalization, the TPA needs to be intimated within 24 hours of getting admitted.
      • Fill out and submit the cashless authorization form to the TPA. In case more documents or information is required, the TPA department will get in touch with you.
      • The TPA will crosscheck your policy coverage and approve your cashless treatment request within 3 hours.
      • During discharge, pay for anything that your insurance policy does not cover.
      • After your discharge, the TPA will pay the bill amount directly to the network hospital.

      Claim Process for Reimbursement Treatment:

      The steps to file a Royal Sundaram health insurance reimbursement claim are given below:

      • Notify the Royal Sundaram General Insurance Company about your emergency hospitalization within 24 hours and planned hospitalization at least 72 hours in advance.
      • Pay all the medical bills at the hospital during discharge and take all the documents home.
      • You need to submit a duly filled and signed claim form along with other supporting documents to the insurer within 30 days of getting discharged from the hospital.
      • The insurer will review the documents and approve or reject the claim. Upon approval, your claim amount will be processed within 30 days of submitting the documents.
      • The claim will be rejected only if there is a discrepancy. In that case, the insurer will issue a rejection letter.

      Documents Required for Royal Sundaram Health Insurance Claims

      Here are some of the crucial documents that you need to submit at the time of filing a Royal Sundaram health insurance claim:

      • Health insurance claim form
      • Doctor’s prescriptions for medicines and payment receipts
      • First consultation papers
      • Hospital discharge summary
      • Medical reports, like ECG, X-rays, MRI, CT scans, pathology reports etc.
      • Doctor’s prescription advising hospitalization
      • Death summary (in case of death of the insured)
      • Original copies of final hospital bills and payment receipts
      • FIR or MLC (for accident cases)

      For more details, you can speak to the customer care team at Policybazaar.com at 1800-208-8787 or write to us at care@policybazaar.com.

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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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