Aditya Birla Claim Settlement Ratio

Aditya Birla Claim Settlement Ratio

Buying health insurance without knowing the company’s performance can cause problems during medical emergencies. One such factor you should always check when 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? Read along to explore more about the Claim Settlement Ratio and its significance.

What is a Claim Settlement Ratio?

The Claim Settlement Ratio (CSR) is the percentage of claims paid by an insurance company. It represents the percentage of claims an insurer settles during a financial year. This ratio compares the total number of claims received to the number of claims settled.

The formula for CSR is: (Number of Claims Settled / Number of Claims Received) x 100

According to the latest report published by IRDAI in 2025, Aditya Birla Health Insurance Company's Claim Settlement Ratio is 92.97%.

How is a CSR Beneficial to Policyholders?

Before purchasing any goods, consumers often research their dependability and the brand's reputation. The same principle applies to purchasing health insurance. Checking an insurer's Claim Settlement Ratio provides insight into its efficiency in settling claims.

It also provides information about the company’s capacity to settle claims. A higher CSR indicates a greater capacity for the company to settle claims.

Buying a health plan from a company with a good Claim Settlement Ratio helps you and your family during medical emergencies.

Let’s understand this with a simple example:

Mr. Arora bought health insurance, but when his wife needed surgery, his health insurance company delayed the claim settlement process, causing distress to his family members.

This example highlights why 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 those of other top insurers.

Aditya Birla Health Insurance Network Hospital List

Aditya Birla Health Insurance network hospitals are present in 32 states nationwide. With a wide network of over 10,051+ cashless hospitals, Aditya Birla Health Insurance ensures that you are medically covered, regardless of your city of residence.

Types of Aditya Birla Health Insurance Claims

There are two types of health insurance claims you can choose from at your convenience:

• Cashless Claim
• Reimbursement Claim

Let us take a look at both types of claim filing processes:

Cashless Claim Process

• To avail of the cashless facility, you need to get admitted to any of the network hospitals of Aditya Birla Health Insurance Company.
• At the network hospital, show the cashless card of Aditya Birla Health Insurance and valid ID proof like a passport, PAN card, voter ID, etc.
• Once the identification is done, the network hospital will send the cashless hospitalization request form to the company.
• The company will review the form. After completion of the formalities, the decision will be forwarded to you through SMS and email.
• Once approved, payment will be made directly to the network hospital.

For planned hospitalization, the form must be submitted 3 days in advance. For emergency cases, it must be submitted within 48 hours of hospitalization.

Reimbursement Claim Process

If you are admitted to a non-network hospital, you have to pay the hospital directly after treatment.

To file a reimbursement claim, submit the following documents to Aditya Birla within 15 days of discharge:

The documents required are:

• Claim form (Part A & B)
• Health card
• KYC documents
• Original discharge summary
• Hospital bills
• Invoice with payment receipt
• All consultation papers/reports
• Others

After reviewing the documents, Aditya Birla will make an appropriate decision. If approved, the amount will be reimbursed via NEFT to your registered bank account.

The company must be informed within 48 hours (in case of emergency hospitalization) and 3 days prior to admission (for planned hospitalization).

How can I track my Aditya Birla Claim Status?

To check the claim status of your Aditya Birla Health Insurance policy, follow these steps:

• Visit the official website of Aditya Birla Health Insurance Company.
• Click on the 'Claims' section, and from the drop-down menu, select "Check Claim Status," and then click "Track Claims."
• On the next page, fill in your credentials and log in.
• Once logged in, you can easily view your claim status.

Conclusion

Aditya Birla Health Insurance’s Claim Settlement Ratio of 92.97% as of 2025, coupled with its extensive network of over 10,051 cashless hospitals, demonstrates a strong commitment to supporting policyholders during medical emergencies. Choosing a health insurance provider involves a comprehensive evaluation of coverage, network, and claim settlement efficiency, empowering individuals to make informed decisions for their health and financial well-being.

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