Care Health Insurance Claim Settlement
The claim settlement ratio (CSR) helps customers understand if the insurance company will pay their claims on time. A higher CSR means the company is reliable and has a good track record of settling claims. Generally, a CSR above 85% is considered good. It is calculated using the formula:
Claim Settlement Ratio = (Total claims settled ÷ Total claims received) × 100
Care Health Insurance has an 88.6% claim settlement ratio for the 2023-24 financial year, showing that most claims are successfully settled. This makes it a trustworthy choice for policyholders. Additionally, Care Health Insurance provides 24/7 customer support to assist with claim-related queries at any time.
Documents Needed for Care Health Insurance Claims
When filing a Care Health Insurance reimbursement claim, you need to provide the following documents:
- Filled and signed claim form (original copy)
- Photo ID proof
- Doctor’s prescription for hospitalization
- List of medical tests, consultations, and medicines from the doctor
- Hospital discharge card
- Indoor case papers
- Original bills and receipts (hospital and chemist)
- Medical test reports with receipts (original copies)
- Police FIR report (if needed)
- Original post-mortem report (if needed)
How to Claim Care Health Insurance
Care Health Insurance makes it easy to claim money for both cashless treatment and reimbursement. Here’s how you can do it:
1How to Get Cashless Treatment?
If you are getting treatment at a network hospital, follow these steps:
- Inform the Insurance Team: Call customer care 48 hours before planned hospitalization or within 24 hours of an emergency.
- Submit Pre-Authorization Form: Fill out the form and give it to the hospital’s insurance desk. The hospital will send it to Care Health Insurance for approval.
- Approval Process: The insurance company will review the request and approve or reject it.
- Claim Settlement: After you are discharged, the insurance company will directly pay the hospital for your treatment.
2How to Claim Reimbursement?
If you pay the hospital bills yourself, you can get your money back by following these steps:
- Inform the Insurance Team – Call customer care 48 hours before a planned hospitalization or within 24 hours of an emergency.
- Pay Hospital Bills – Pay all hospital bills at the time of discharge and collect all documents.
- Submit the Claim – Fill out the claim form and send it to the insurance company along with all required documents.
- Claim Review – The insurance company will check the documents and approve or reject the claim. If rejected, they will provide a reason.
- Receive Payment – If approved, the insurance company will refund the money to you.
Following these steps will help ensure a smooth and fast claim process.
FAQs
Care Health Insurance offers two ways to settle claims:
- Cashless Claims: If treated at a network hospital, bills are settled within 6 hours.
- Reimbursement Claims: If you pay first, you can get your money back in at least 7 days.
Yes! You can track your claim online easily. This helps you stay updated and avoid stress. You can also check your policy details or download your documents through Square Insurance.
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