Iffco Tokio Health Insurance Claim Settlement Ratio

When considering an insurance company, one crucial aspect to evaluate is its claim settlement ratio. It determines the number of claims paid by the company compared to the total number of claims filed in a given financial year. A higher claim settlement ratio implies a greater likelihood of having your claim settled promptly and efficiently.

Iffco Tokio Health Insurance Company, established in 2000, is among the oldest insurance companies in India, boasting a network of over 7000 hospitals. As per the latest annual report for 2023-24, Iffco Tokio Health Insurance has achieved commendable numbers, reflecting its growth across all aspects. This reflects the company’s commitment to fulfilling its policyholders’ claims promptly.

Types of Claim Settlement Processes at Iffco Tokio

Iffco Tokio Health Insurance offers two types of claims filing processes to cater to the diverse needs of its customers:

• Cashless Claims
• Reimbursement Claims

Let’s delve into the details of each claim process.

Iffco Tokio Health Insurance Cashless Claim Process

Here’s a step-by-step overview of the cashless claim process for Iffco Tokio Health Insurance:

Step 1: To avail cashless treatment, visit one of the company's network hospitals. You can find the list of network hospitals on the company's website.

Step 2: Notify the hospital 72 hours before planned hospitalization, or within 24 hours in case of an emergency.

Step 3: The policyholder must fill out the intimation form for cashless treatment and submit it to the TPA.

Step 4: After receiving the duly filled claim form, the TPA will issue a pre-authorization letter to the hospital.

Step 5: After treatment, the policyholder will sign the discharge papers and settle any non-medical expenses.

Step 6: The hospital will send all bills to the TPA. After verification, the company will settle the claim within 7 days.

Iffco Tokio Reimbursement Claim Process

In a reimbursement claim, the policyholder pays medical expenses upfront and then seeks reimbursement from the insurance company for the costs incurred. Iffco Tokio Health Insurance allows reimbursement claims to be filed for both network and non-network hospitals. Here’s an outline of the reimbursement claim process:

Step 1: The policyholder can undergo treatment at a network or non-network hospital.

Step 2: Essential documents, including the reimbursement claim form, must be submitted to the TPA or company within 30 days from the date of discharge.

Step 3: After receiving and reviewing the documents, the insurer will approve the claim. If accepted, the payment will be transferred directly to the policyholder’s bank account.