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Aditya Birla Health Insurance Claim Settlement
The claim settlement ratio shows how many claims the insurance company is likely to settle in a year. It's calculated using this formula:
Claim Settlement Ratio (CSR) = (Claims settled / Claims received) * 100
A ratio above 85% is considered good. Aditya Birla Health Insurance has a high claim settlement ratio of 94.52% for the year 2023-24.
Claim Process of Aditya Birla Health Insurance
Aditya Birla Health Insurance offers both cashless and reimbursement claim options. Here's how the claim process works:
Claim Process for Cashless Treatment
Get admitted to a network hospital that accepts cashless claims.Inform Aditya Birla Health Insurance about your emergency hospitalization within 48 hours, or at least 3 days before planned hospitalization.Show your health insurance card and policy number, and provide a valid ID like a PAN card or passport.Fill out the cashless pre-authorization form and submit it to the hospital. The hospital will send the form to the insurer.The insurer will review the details and notify the hospital within 2 business hours. You can also check the status online.If the claim is approved, the insurer will pay the hospital directly after you are discharged.
Claim Process for Reimbursement Treatment
Inform the insurer within 48 hours of an emergency hospitalization, or 3 days before planned treatment.Get the treatment and pay the medical bills when you are discharged.Submit all required documents, including the filled reimbursement claim form.The insurer will review all documents and notify you of the decision by call or email.Once approved, the insurer will reimburse the claim amount.
Health Insurance Plans By Aditya Birla
FAQs
Aditya Birla Health Insurance usually settles claims within 7 working days after it receives all the required documents. It will not take more than 30 days.
You should submit the reimbursement claim within 15 days after you are discharged from the hospital or clinic.
You can check your claim status online by visiting the Aditya Birla Health Insurance website or calling their customer care number.
You need your health card, hospital bills, doctor's prescription, discharge summary, and test reports. Make sure to keep copies of all documents.