Niva Bupa Claim Settlement Ratio
  • Explore What is CSR
  • Check And Compare The CSR of Niva Bupa
  • Learn how to file Niva Bupa Claims
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Niva Bupa Claim Settlement Ratio

Health Insurance these days is nothing less than a necessity. Having an ideal Health Insurance plan ensures that you and your family are protected from a financial bubble during announced medical emergencies. But have you ever thought about what will happen if your Insurance company is not able to settle your claims on time? What will happen to your loved ones if they are not able to avail the benefit of having Health Insurance? All your savings will be wiped off. Your family might have to suffer due to these untoward situations.

To avoid yourself and your family from such a senario, it is recommended to always check the claim settlement ratio before buying your ideal health insurance company.

Now you must be wondering what is a Claim Settlement Ratio, and how is it important? Read along to find out yourself.

Health Insurance Claim Settlement Ratio

What is a Claim Settlement Ratio?

Claim settlement ratio or CSR is the percentage of claims that an insurance company settles during a financial year against the total number of claims raised. It acts as an indicator of their credibility.

It is recommended to go with a company that has a higher claim settlement ratio, as the general rule is the higher the ratio, the more reliable the health insurance company is. This factor tells you the ability of the company to settle claims and helps you understand the history and performance of the insurer.

If by now you have decided to buy a health insurance plan by Niva Bupa Health Insurance, then, lets discuss the Niva Bupa Health Insurance claim settlement ratio in a little more precise way.

According to the IRDAI Annual Report 2020-21, Niva Bupa settles 99.93% of claims within 3 months. The higher the percentage of claim settlement ratio, the better the ability of an insurance company to settle claims. Hence, the high claim settlement ratio makes Niva Bupa Health Insurance trustworthy for its valued customers.

As per the IRDAI Annual Report 2020-21, if we look at the Claim Settlement ratio of other companies, the Niva Bupa settlement ratio comes in the top five.

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Status of Niva Bupa Claim Settlement Ratio - 2020-21

Status of Niva Bupa Claim Settlement Ratio - 2020-21
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 99.93 0.06 0.00 0.00 0.00 0.00

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How To File a Niva Bupa Health Insurance Claim?

For Cashless Claims:

  • Get admitted to any one of the network hospitals associated with Niva Bupa. You can check the list of network hospitals on the company’s website.
  • Use your Niva Bupa Health Card and show them your identification proof.
  • After validating your identity, the network hospital will submit the pre-authorization request form to the company.
  • The company will review your request and provide the confirmation to the network hospital by fax or email and share the same with you via text or email.
  • The company will settle the claim with the hospital after the completion of all formalities.

Reimbursement Claim Settlement Process

  • If admitted to a non-network hospital, notify Niva Bupa within 48 hours of hospitalization. In emergency cases, inform them within 24 hours of hospitalization.
  • You need to pay the treatment expenses to the hospital. During discharge, collect all necessary documents, invoices, medical reports, and discharge certificates from the hospital.
  • Send the completed claim form (available on Niva Bupa’s website) along with the required documents to Niva Bupa.
  • Niva Bupa will review the documents and settle the claim (if approved) by reimbursing you for the amount.

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Naval Goel

Reviewed By : Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.