Navi Health Insurance Claim Settlement Ratio

Checking the Navi Health Insurance Claim Settlement Ratio is one of the important things that should be kept in mind. Having a clear picture of how the company performs can help you and your family from further stress that you may face at the time of an unannounced medical emergency.

In the article below, we will discuss the Navi General Insurance Claim Settlement Ratio.

What is the Claim Settlement Ratio?

The claim settlement ratio (CSR) acts as an indicator that compares the proportion of health insurance claims settled by an insurer during a financial year against the total number of claims raised. This one factor gives you an idea of the reliability of the health insurance company. Every year, the Insurance Regulatory and Development Authority of India (IRDAI) releases the claims settlement details of general and health insurance companies enabling the customers to analyze the claim settlement ratios of all the insurance providers in India and make an informed decision for the betterment of their future.

Navi General Insurance Claim Settlement Ratio

Since now you know the what claim settlement ratio is, let us give you an insight into Navi Health Insurance’s claim settlement performance. For health insurance companies this ratio is published for different periods such as less than 3 months, 3 months to 6 months to up to 5 years. In the below table, you can check the current Navi Health Insurance claim settlement Ratio under the time frames stated above.

Status of Navi Health Insurance Claim Settlement Ratio - 2021-22

What is the Claim Procedure of Navi Health Insurance Plans?

• Cashless Claims: wherein the insurance company settles the medical bill directly with the hospital. It works as a great way to lessen the burden on the customers
• Reimbursement Claims: wherein the policyholders are required to clear their medical expenses arising out of hospitalisation first and then raise a reimbursement claim by submitting proper medical bills and documents.

The claim procedures for both these methods are described below.

Cashless Claim Procedure

• Intimate the company about your claim request by calling its toll-free number or writing an email.
• For planned hospitalisation, notify the company at least 48 hours before admission. In case of emergency hospitalisation, the claim notification should be sent to the company within 24 hours of admission to the hospital or before discharge whichever is earlier.
• Provide the health card along with photo identification proof of the policyholder to the hospital authorities.
• Duly fill out the cashless request form and submit it to the hospital.
• The pre-authorisation request form will be sent by the hospital to the cashless department of TPA.
• At the time of discharge, the hospital will forward a final authorisation request.
• The discharge will be done post receipt of the final authorisation letter by the hospital.

Reimbursement Claim Procedure

• Customers are required to settle all the hospital bills.
• At the time of discharge, he/she must collect all the important documents provided by the hospital including the discharge summary and bills.
• Submit all these documents to the company or Third-Party Administration within 15 days from the date of discharge.
• The company will verify all the documents. On approval, the claim amount will be released.