Aditya Birla Claim Settlement Ratio
  • Explore the CSR process of Aditya Health
  • Know the significance of a good CSR
  • Claim Filing procedure
Aditya Birla Claim Settlement Ratio
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Aditya Birla Claim Settlement Ratio

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.

What is a Claim Settlement Ratio?

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

Claim Settlement Ratio of Aditya Birla Health Insurance Company

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 months3 months to 6 months6 months to <1 year1 year to <3 year3 years to <5 years5 years
Claims Settled99.410.260.050.280.000.00

How is a CSR Beneficial to Policyholders?

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 Hospital List

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.

Types of Aditya Birla Health Insurance ClaNetwork Hospitalsims

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

  • Cashless Claim
  • Reimbursement Claim

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

Cashless Claim

  • To avail of the cashless facility, you need to get admitted to any of the network hospitals of Aditya Health Insurance company.
  • At the network hospital, show the cashless card of Aditya Birla Capital Health Insurance and valid ID proof like a Passport, PAN Card, Voting card, 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 E-mail.
  • Once approved, the payment will be made to the network hospital.

 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:

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

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).

How can I track my Aditya Birla Claim Status?

To check the claim status of your Aditya Birla Health Insurance policy, follow the below 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 on Track Claims.
  • On the next page, fill in your credentials, and log in.
  • Once done, you can then easily see the status of your claim on the page.

Aditya Birla Health Insurance Network Hospital List

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.

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To cater to the different medical needs of an individual & their family, Aditya Birla Health Insurance offers several Health Plans ranging from senior citizen plans to specialized plans for autistic children, to health insurance for cardiac patients, and many more.Take a look below to Aditya Birla Health Insurance plans explore more:

Critical Illness Health Insurance

Aditya Birla Cancer Secure health plan is a health insurance plan designed specifically for cancer patients protecting them financially from all three...

Unique Features

  • Upto 1 Cr SI
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Aditya Birla Cancer Health Plan (Pros)

Aditya Birla Cancer Health Plan
  • Covers 3 stages
  • 150% of SI
  • 10% of no claim bonus
  • High SI
  • Lump sum payout

Aditya Birla Cancer Health Plan (Cons)

Aditya Birla Cancer Health Plan
  • Illness due to intoxicants
  • Obesity treatment unavailable
  • Hazardous activity not covered
  • HIV/AIDS not covered
  • Cosmetic surgery unavailable

Aditya Birla Cancer Health Plan (Other Benefits)

Aditya Birla Cancer Health Plan
  • Wellness coach
  • Second e-opinion
  • Short survival period
  • Upto 1 Cr SI
  • Hospitalization Expense

Aditya Birla Cancer Health Plan (Eligibility Criteria)

Aditya Birla Cancer Health Plan
  • Entry Age- 18 Years
  • Max Entry Age- 65 Years
  • SI- 5L to 1 Cr
  • Waiting Period- 90 days

Accident Health Insurance

Aditya Birla Activ Secure Personal Accident Plan is designed to protect you and your family in case of any unforeseen incident. Activ secure personal ...

Unique Features

  • Up to 20 Cr SI
  • 11 Optional Covers
  • Avail Wellness Benefit

Aditya Birla Personal Accident Plan (Pros)

Aditya Birla Personal Accident Plan
  • Total and partial disability cover
  • Accidental death cover
  • No claim bonus
  • Ambulance cover
  • Education benefit

Aditya Birla Personal Accident Plan (Cons)

Aditya Birla Personal Accident Plan
  • Illness due to intoxicants
  • Obesity treatment unavailable
  • Hazardous activity not covered
  • Cosmetic surgery unavailable

Aditya Birla Personal Accident Plan (Other Benefits)

Aditya Birla Personal Accident Plan
  • Income cover
  • Loan protect cover
  • Orphan benefits
  • Compassionate visit
  • Coma benefit

Aditya Birla Personal Accident Plan (Eligibility Criteria)

Aditya Birla Personal Accident Plan
  • Entry age- 5 years
  • Max entry age- 65 years
  • SI- 30L
  • Waiting period- 30 days

Individual and Family Health Insurance

Aditya Birla Platinum Enhanced Plan offers unique healthcare benefits to insured individuals such as health insurance protection with wellness benefit...

Unique Features

  • Critical Illness Cover
  •  Health Coach
  •  SI Up to 2 Crores

Aditya Birla Activ Health Platinum Enhance (Pros)

Aditya Birla Activ Health Platinum Enhance
  • Earn 100% health returns
  • Cover for dental consultations
  • Modern treatment cover
  • Wellness coach
  • Mental illness cover

Aditya Birla Activ Health Platinum Enhance (Cons)

Aditya Birla Activ Health Platinum Enhance
  • Illness due to intoxicants
  • Change of gender treatment
  • Hazardous activity not covered
  • HIV/AIDS not covered
  • Cosmetic surgery unavailable

Aditya Birla Activ Health Platinum Enhance (Other Benefits)

Aditya Birla Activ Health Platinum Enhance
  • Chronic management program
  • Premium waiver benefit
  • Reload of SI
  • Road ambulance cover
  • Second e-opinion

Aditya Birla Activ Health Platinum Enhance (Eligibility Criteria)

Aditya Birla Activ Health Platinum Enhance
  • Entry age- 90 days
  • Max entry age- 45
  • SI- 1L to 1 Cr
  • Waiting period- 30 days

Individual and Family Health Insurance

Aditya Birla Activ Fit Plan is designed to provide quality medical coverage to young individuals. The plan not only provides medical coverage but als...

Unique Features

  • Health Rewards
  • Avail Multiple Discounts
  • Optional Covers Available

Aditya Birla Activ Fit Health Plan (Pros)

Aditya Birla Activ Fit Health Plan
  • Provides health reward for keeping yourself healthy
  • gives optional benefits
  • Get maternity expense benefits

Aditya Birla Activ Fit Health Plan (Cons)

Aditya Birla Activ Fit Health Plan
  • Does not cover air ambulance
  • No coverage for global treatment

Aditya Birla Activ Fit Health Plan (Other Benefits)

Aditya Birla Activ Fit Health Plan
  • Health Rewards
  • Avail Multiple Discounts
  • Optional Covers Available

Aditya Birla Activ Fit Health Plan (Eligibility Criteria)

Aditya Birla Activ Fit Health Plan
  • Entry Age - 18
  • Maximum Entry Age - 65
  • SI -4-25 Lakh
  • Waiting Period - 30 days

Critical Illness Health Insurance

Aditya Birla Activ Secure Critical Illness Plan is designed to cover your financial losses due to any treatment for critical illness. The plan has wid...

Unique Features

  • 64 Critical Illnesses Covered
  • Replace Loss of Income
  • Short Survival Period

Aditya Birla Activ Secure Critical Illness Plan (Pros)

Aditya Birla Activ Secure Critical Illness Plan
  • 64 Critical Illnesses Covered Replace
  • Loss of Income
  • Short Survival Period

Aditya Birla Activ Secure Critical Illness Plan (Cons)

Aditya Birla Activ Secure Critical Illness Plan
  • Does not cover maternity
  • Does not cover any congenital illness
  • Does not cover any evaluation purposes

Aditya Birla Activ Secure Critical Illness Plan (Other Benefits)

Aditya Birla Activ Secure Critical Illness Plan
  • The sum insured of this plan is of up to 1 Cr
  • It comes in three different variants - Plans 1/ 2/ 3 with specific coverage options

Aditya Birla Activ Secure Critical Illness Plan (Eligibility Criteria)

Aditya Birla Activ Secure Critical Illness Plan
  • Min- 5 years
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Senior Citizen Health Insurance

Growing old comes with several complications related to our health, at times. It's so natural that nobody could deny accepting the complications and s...

Unique Features

  • 360 degrees support to seniors
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  • 586 category of daycare procedures

Aditya Birla Activ Care Classic Plan (Pros)

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  • 360 degrees support to seniors
  • Cashless home treatment
  • 586 category of daycare procedures

Aditya Birla Activ Care Classic Plan (Cons)

Aditya Birla Activ Care Classic Plan
  • Does not cover modern treatments
  • Vaccinations not covered
  • Compassionate travel not covered

Aditya Birla Activ Care Classic Plan (Other Benefits)

Aditya Birla Activ Care Classic Plan
  • Tax benefits
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Aditya Birla Activ Care Classic Plan (Eligibility Criteria)

Aditya Birla Activ Care Classic Plan
  • Min- 55 years
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Individual and Family Health Insurance

Aditya Birla Activ One Plan comprises features such as: Health returns Health assessment Daycare treatments No capping on hospitalization expenses Me...

Unique Features

  • Health Rewards
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  • Optional Covers Available

Aditya Birla Activ One (Pros)

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  • Chronic illness covered
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Aditya Birla Activ One (Cons)

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  • Daily hospital cash not covered
  • OPD charges not covered
  • Maternity not covered

Aditya Birla Activ One (Other Benefits)

Aditya Birla Activ One
  • Initial waiting period 30 years

Aditya Birla Activ One (Eligibility Criteria)

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Individual and Family Health Insurance

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Aditya Birla Activ Fit Plus Plan (Pros)

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  • Pre-hospitalization cover
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  • Modern treatment cover
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Aditya Birla Activ Fit Plus Plan (Cons)

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  • Obesity/ weight control
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  • External providers
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Aditya Birla Activ Fit Plus Plan (Other Benefits)

Aditya Birla Activ Fit Plus Plan
  • 10-50-100 benefits
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Aditya Birla Activ Fit Plus Plan (Eligibility Criteria)

Aditya Birla Activ Fit Plus Plan
  • Entry Age - 91 days
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  • SI - 5 L - 1 Cr
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Individual and Family Health Insurance

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  • One premium waiver
  • Health assessment
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Activ Health Platinum (Cons)

Activ Health Platinum
  • Illness due to intoxicants
  • change of gender treatment
  • Hazardous activity not covered
  • HIV/AIDS not covered
  • Cosmetic surgery unavailable

Activ Health Platinum (Other Benefits)

Activ Health Platinum
  • Road ambulance cover
  • No claim bonus
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Activ Health Platinum (Eligibility Criteria)

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  • Entry age- 91 days
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Individual and Family Health Insurance

Aditya Birla Activ Health Platinum Essential Plan is your best friend if you are looking for a health insurance cover that protects you against chroni...

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  • Chronic management program
  • Mental illness cover
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  • Obesity treatment

Activ Health Platinum Essential (Cons)

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  • Change of gender treatment
  • Hazardous activities not covered
  • HIV/AIDS not covered
  • Cosmetic surgery unavailable

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Activ Health Platinum Essential
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Activ Health Platinum Essential (Eligibility Criteria)

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Written By: Naval Goel

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.