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Buying Health Insurance without knowing the company’s performance can cause problems during medical emergencies. One such factor that you should always check at the time of buying Health Insurance is its Claim Settlement Ratio (CSR). Why? Because what’s the need for a health insurance plan if your health insurance company is unable to settle your claims on time.
Didn’t understand? Well, read along to explore more about the Claim Settlement Ratio and its significance.
The claim settlement ratio or CSR is the percentage of claims that have been paid by an insurance company. In other words, it is the percentage of claims paid out by an insurer during a financial year. The ratio compares the number of claims filed to the number of claims settled.
Health Claim Settlement ratio a number of claims settled/number of claims received x 100
As per IRDAI, Aditya Birla health insurance Claim Ratio is 99.41%. Take a look at the below given table that will let you get an insight into the ability of Aditya Birla Claim Settlement.
Status of Aditya Birla Health Insurance Claim Settlement ratio- 2021-22 | ||||||
Age Analysis of Number of Claims Paid (%) | < 3 months | 3 months to 6 months | 6 months to <1 year | 1 year to <3 year | 3 years to <5 years | 5 years |
Claims Settled | 99.41 | 0.26 | 0.05 | 0.28 | 0.00 | 0.00 |
Before purchasing any new goods, we investigate their dependability as well as the brand’s reputation. The same is true when purchasing health insurance. Checking the company’s claim settlement ratio might provide insight into how the company is functioning in terms of claiming settlement.
It will also provide you with information about the company’s capacity to settle claims. The higher the claim settling ratio, the more capable the firm is of settling claims.
Buying a Health plan from a company that possesses a decent claim settlement ratio helps you and your family at the time of announced medical emergencies.
Let’s understand this with a simple example:
Mr Arora bought health insurance, but at the time of his wife’s surgery his health insurance company delayed the claim settlement process, which resulted in distress among the family members.
With the above example, it is imperative to check the claim settlement ratio of your chosen company. If you have decided to buy health insurance from Aditya Birla, do not forget to check the claim settlement ratio of aditya birla health insurance and compare it with other top isurers.
Aditya Birla Health Insurance Network Hospitals are present in 32 states nationwide. With a wide network of over 10051+ cashless hospitals, Aditya Birla Life Insurance ensures that you are medically secured, irrespective of the city you reside in.
There are two types of health insurance claims you can choose from at your own convenience:
Let us take a look at both types of claim filing processes:
Cashless Claim
For planned hospitalization, the form needs to be submitted 3 days in advance. For emergency cases, it needs to be submitted within 48 hours after hospitalization.
Reimbursement Claim
If you are admitted to a non-network hospital, you have to pay the hospital directly after the treatment is done.
1. To file a claim, submit the documents to Aditya Birla within 15 days of discharge:
The documents required are:
2. After reviewing the documents, Aditya Birla will take the appropriate decision and if approved, the amount will be reimbursed through NEFT to the registered bank account.
You need to inform the company within 48 hours (in case of emergency hospitalization) and 3 days before your admission (for planned hospitalization).
To check the claim status of your Aditya Birla Health Insurance policy, follow the below steps:
Aditya Birla Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, Aditya Birla Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
Aditya Birla Health Insurance
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Naval Goel is the Founder and CEO of PolicyX.com (IRDA- Approved Insurance Comparison Website). He is a CFA charter holder (USA) and FRM (GARP). He holds an MBA from IIFT, Delhi, and is also an Associate from the Insurance Institute of India. Naval is an avid investor and entrepreneur who has a deep understanding of the Indian equity market and insurance sector. He has been investing for more than 10 years now and is a CFA charter holder.
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