Kotak Health Insurance Claim Settlement Ratio

Choosing a health insurance company can be a daunting task, it can leave you wondering how to pick the best one among all the companies present in the Indian market. It’s usually advised to notice the insurance company’s data, which can give you an insight to understand if the insurer is dependable or not. This is why we look for the claim settlement ratio of a company. Claim Settlement Ratio can be defined as the number of claims paid by the health insurance company against the number of claims made in a year. For example, Kotak Health Insurance Company has a claim settlement ratio of 96% which means that the insurance company has settled 96 claims out of 100 claims for the year 2021 - 2022.

Kotak General Insurance Claim Settlement Ratio

Kotak Health Insurance has a smooth and fast claim settlement process, it's quite easy and does not cause inconvenience to the policyholder . The company has a Claim Settlement Ratio of 96.90% which is the reflection of its reliability for its customers.

Types of Claims by Kotak Health Insurance Company

Kotak Health Insurance Company offers two types of claims-settling processes to its customers. These are-

• Cashless Claims
• Reimbursement Claims

Cashless Claims?

In this claim process the insurance company settles the medical bill directly with the hospital. This claim settlement process is most famous among the two claim settlement processes.

Health Insurance Claim Settlement Ratio

Kotak Health Insurance Cashless Claims

The company has tie-ups with most of the leading hospitals in the country where customers can avail of cashless claim settlements. The company has a network of more than 7000 cashless hospitals. Kotak General Insurance offers the benefit of cashless claims to save its policyholders from worrying about medical expenses borne by their own pocket.

Process of filing a Kotak Health Insurance Cashless Claim

Kotak General Insurance Company has a simple, app-based claim process to make your experience with the customer fuss-free. You can contact the company for a claim, submit your documents, and check your claim status easily on their customer app’ Kotak Mahindra General Insurance' and on their official website as well. Let’s go through the Kotak Health Insurance Cashless Claim process step by step.

Step 1: Customers must find a Kotak Health Insurance network hospital near them where they want to avail of the cashless treatment.

Step 2: For planned hospitalization, the customer must inform the company within 24 hours and in case of emergency hospitalization and 48 hours after the admission.

Step 3: Policyholders must show their card/policy number of the member ID provided by Kotak Health Insurance, at the insurance desk of the network hospital.

Step 4: You can get the pre-authorisation form at the hospital, and fill in all the required information. Then, the pre-authorisation form will be sent to Kotak Health Insurance Company for approval.

Step 5: After the claim details and documents are examined and reviewed Kotak Health Insurance team will inform the policyholder and hospital regarding the claim approval or rejection.

Step 6: If the claim is approved, the medical expenses will be sent to the hospital directly. But, if the claim is rejected, the policyholder will be required to pay the bills and other expenses.

Health Insurance Companies

Reimbursement Claims

In this process the policyholders have to clear their medical expenses that are out of hospitalization from their own pocket and then raise a reimbursement claim by submitting proper medical bills and documents.

Kotak Health Insurance Reimbursement Claims

In this process the policyholders have to clear their medical expenses that are out of hospitalization from their own pocket and then raise a reimbursement claim by submitting proper medical bills and documents. A customer can file a reimbursement claim at both, network and non-network hospitals of Kotak Health Insurance Company. Here are the steps for the reimbursement claim process:

Step 1: In case of planned hospitalization, the person must inform them before 48 hours of admission.

Step 2: In case of emergency hospitalization, a person should intimate Kotak Health Insurance Company within 24 hours of hospitalization.

Step 3: The policyholder must submit a claim form with all the essential documents within 30 days of discharge from the hospital.

Step 4:After reviewing the submitted documents and claim form details, the letter of approval and confirmation will be sent to the policyholder by the claim management team of Kotak Health Insurance. After verification, the claim will be settled within 15 days.

Step 5:In case of rejection, the insured individual is required to respond to the query raised by Kotak Health Insurance Company and go through the reason for rejection