*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply
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TATA AIG General Insurance Company has established a user-friendly claim settlement process in place. All the Tata AIG health insurance plans allow easy claim registration and settlement. The insurer’s health claim settlement ratio is 96% and it brings enough confidence to buy health insurance from TATA AIG General Insurance Company.
The insurer has a team of experienced claim settlement professionals who ensure timely settlement. Their health claim ratio is the evidence of the good work that the insurance provider is doing. The company helps in meeting the requirements of its customers with both cashless claim and reimbursement claim facility.
Incurred Claim Ratio
Every Health Insurance Company provides two types of claim facilities i.e. cashless claims and reimbursement claims. The details for both of them are given below:
For cashless claim requests, the health insurance companies pay directly to the hospital. You don’t need to wait for payment like in the case of reimbursement. You can avail of emergency treatment and get admitted without worrying about the finances.
Cashless claims mean that you don’t need to pay anything during hospitalization for the expenses that are covered. The insurer pays directly to the hospital (network hospitals only) on your behalf. The claim process for cashless treatment in case of planned hospitalization is given below:
If you have a set date on which you will undergo the surgery or get admitted to the hospital, it is called a planned hospitalization. At that time you need to adhere to the steps as given below:
Step 1: Inform the Health Insurance Company
Submit the cashless claim form to the insurance company via letter or email, at least five days before the treatment.
Step 2: Wait for the Approval letter
Once the insurance company receives your cashless claim form, the hospital will be notified and you will get a confirmation letter. The confirmation letter for cashless claims remains valid for seven days from the date of issuance.
Step 3: Submit the letter of Approval
Once you get admitted to the hospital, you can submit the confirmation letter and the health card. All in your entire job gets finished here. The insurance company will pay the bills directly to the hospital.
You will need to pay the bills first and then apply for its reimbursement. This happens when the health insurer does not offer a cashless claim facility. Or the hospital where you are undergoing treatment is not a part of the insurer’s network of hospitals. To get reimbursement of your medical expenses, you need to adhere to the following steps:
Step 1: Verify the policy details
Before signing the hospital bill, make sure that all the details are accurate. It is crucial to provide the right information, as any discrepancy could hamper the claim process.
Step 3: Follow up for documents
In case all the documents are not available immediately, and you might need to check for a few days to gather all the documents.
Step 4: Submit all the documents
Soon after getting discharged from the hospital, you can submit all the policy documents to the insurance company or the designated TPA, depending on the insurer’s claim process.
Step 5: Wait for processing the payment
Once the TPA or the insurance company receives all your documents, the payment is processed within a span of 21 days from the document submission.
To get reimbursement of your expenses here is the list of documents that you need to submit:
In the case of hospital cash or medical benefits
In case of weekly benefits:
To know more details about you can speak to our customer care team at 1800-208-8787 or write to us at email@example.com
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