ACKO Claim Settlement Ratio
  • Check the CSR of ACKO Health
  • Compare the CSR performance
  • Know the Claim Settlement process
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ACKO Health Insurance Claim Settlement Ratio

A health plan is one of the best things that you can gift yourself and your family. But have you ever thought about what will happen if your Health insurance company is unable to settle your claim? Or what if your claim settlement process is delayed?

The mere thought of struggling with another problem during an ongoing medical emergency is quite petrifying. To avoid such situations, it is best to check the Claim Settlement Ratio of the company you have chosen to buy. Now, you must be wondering about Acko Claim Settlement Ratio and how it helps you avoid the above-mentioned situations.

Well, continue reading to find out for yourself.

What is the Claim Settlement Ratio?

The claim settlement ratio, or CSR, is the percentage of claims that an health insurance company has paid out. To put it another way, it's the proportion of claims paid out by an insurer in a given financial year. The ratio is calculated by dividing the total number of claims filed by the total number of claims settled.

Health Claim Settlement Ratio=Number of claims settled/number of claims received * 100

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Acko General Insurance Claim Settlement Ratio

As per IRDAI, Acko Health Insurance Claim Settlement Ratio is 98%. Take a look at the below table for insight and get the idea of Acko Claim Settlement Ratio

Status of Acko Insurance Claim Settlement ratio- 2021-22
Age Analysis of Number of Claims Paid (%)< 3 months3 months to 6 months6 months to <1 year1 year to <3 year3 years to <5 years5 years
Claims Settled 97.21.670.80.330.000.00

What Is the Claim Procedure of ACKO Health Insurance Plans?

Acko insurance claim settlement ratio showcases that the company understands the need of quick claim settlement and settles your claims on time. The company allows the policyholders to raise claims in two ways:

  • Cashless Claims: wherein, the insurance company settles the medical bill directly with the hospital. and,
  • Reimbursement Claims: wherein the policyholders are required to clear their medical expenses arising out of hospitalisation and then raise a reimbursement claim by submitting proper medical bills and documents.

Read below to get a detailed understanding of the claim settlement Process:

Health Insurance Companies

Online Procedure

  • Get hospitalized in any of the network hospitals empanelled with ACko Health Insurance.
  • Show your health card to the hospital authorities.
  • Duly fill out the cashless request form and submit it to the hospital.
  • After verification, the company will issue a pre-authorization letter to the hospital.
  • At the time of discharge, the insured person has to verify and sign all the medical bills and pay for any non-medical and inadmissible expenses.

Procedure for reimbursement claims:

  • You can file a reimbursement claim if you are not able to get admitted to the network hospitals.
  • Get yourself treated, and settle all the medical bills at the time of discharge.
  • Collect all the documents provided by the hospital such as discharge summary and payment receipts.
  • Submit all the documents to the Third-Party Administration or ACKO company.

Documents Required for Filing ACKO Health Insurance Claim

  • Health insurance claim form
  • Photo ID proof of the patient
  • Medical practitioner's prescription advising admission
  • Original bills and payment receipts
  • Discharge summary including complete medical history of the patient
  • Investigation/ Diagnostic test reports supported by the prescription
  • NEFT Details (to enable direct credit of claim amount in the bank account) and a canceled cheque.
  • KYC (Identity proof with Address) of the proposer, where claim liability is above Rs. 1 Lakh as per AML Guidelines
  • Legal heir/succession certificate
  • Any other relevant documentation as required by Company/TPA for assessment of the claim

The company will verify all the documents. On approval, the claim amount will be released.

Health Insurance Plans by ACKO Health Insurance Company

ACKO Health Insurance offers two different types of health insurance plans to help stay financially protected in medical emergencies. Let's have an overview of these plans.

Standard Plan

Acko Arogya Sanjeevani Policy

Arogya Sanjeevani is a standard indemnity-based health insurance product designed to safeguard the medical requirements of customers.

Unique Benefits

  • Covers Cataract Treatments
  • No Health Check-ups up to 45 years
  • Cumulative bonus of 5% on SI

Group Health Plan

Acko Group Health Insurance Plan

Plan providing coverage for medical expenses arising out of hospitalization for a group of employees/workers of a particular organization.

Unique Benefits

  • Maternity benefit Available
  • Coverage for disabled children
  • Injuries due to Terrorism

Health Insurer Claim Settlement Ratio

Acko Health Insurance Reviews

Customer Review Image

VIJAY KUMAR MAURYA

Gurgaon

June 13, 2023

"I got accident and I m upload my medical bills and reports and on time i got call from the acko and I m explained... The team of acko mam "ANUSHA " Taken my accident claim and d...

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Gurappa pathuru

Bengaluru

June 3, 2023

The company has some of the best health plans from low budget to high. The company provides support 24/7 and does not bother with spam calls.

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Tarun

Ludhiana

February 21, 2023

I got payment with in 3 working days. I am glad how Vomitha ma am who s the executive, listen me carefully and release the payment directly to my account. Thanks Acko

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Sachin abhyankar

Pune

September 16, 2022

Very affordable Acko plans. Provide coverage for every health issue and are ready to help anytime any day.

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nandini

Dehradun

February 21, 2022

ACKO is no 1 insurance company. made process very easy for me when my nani fell sick and i was only with her but the insurance company arranged everything.

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Sheersha Kundra

Bengaluru

October 28, 2021

The company has various affordable plans also they have an amazing customer care team that helps their customer in their time of need.

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Mahaveer Singh

Delhi

September 6, 2021

Very good company, with best customer services. Health Insurance plans offered by the company are also very good.

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Kavita Kumari

Guwahati

September 6, 2021

impressive work done by Acko Health Insurance, and its customer suppost. Keep serving us like this. well done

View All Acko Health Insurance Reviews

Naval Goel

Reviewed By : Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.