Care Health Claim Process
- Claim Process
- Cashless Claims
- Reimbursement Claims
Claims are the financial compensation provided by the insurance company to the policyholder, to cover the financial loss incurred due to any medical situation. Filing a claim can be a tedious task, especially at the time of any medical emergency. So, Care Health Insurance Company has designed an easy and efficient process for filing a claim. The company has a dedicated team to assist the customer at every step of making the claim. The Claim Settlement Ratio of the company is 100% (for 3 months) which translates that they go above and beyond to provide a seamless claim settlement process. Here is a comprehensive look at the Care Health Insurance Claim.
Cashless Claims: The policyholder can get treatment at a network hospital without worrying about the payment. Care Health Insurance company will later settle the hospital bill directly.
Reimbursement Claims: If the policyholder chooses a non-network hospital for treatment, they pay the expenses initially and then get the compensation after submitting the valid documents.
Both cashless and reimbursement claims are processed differently and documents asked for each are also handled differently. In the claim process, the policyholder has to inform the company first, then submit the documents and after successful verification, the claims are settled. Now let us examine each type of procedure separately.
Cashless claims are the fastest way of filing a claim and they are settled directly between the insurer and the network hospital. Following are steps to file a cashless claim:
Step 1: Visit the network hospital and contact the TPA desk of the hospital. Ask for a pre-authorization form.
Step 2: With the assistance of the TPA, fill in all the details in the pre-authorization form, attach all the necessary documents as suggested by the TPA and submit the details via email.
Step 3: The company will verify all the submitted details and it may ask for additional documents if necessary.
Step 4: Once all the documents are submitted, the company will verify them and then settle the claims directly with the hospital.
Note:
Reimbursement claims give the opportunity to the policyholder to choose the hospital where he wants to receive the treatment. Here are the steps required to process these claims:
Step 1: Submit the claim along with the claim from the TPA desk or mail it to the company.
Step 2: After verification, the hospital il notify the insured, through a text message or an email. The company can even send a claim approval letter.
Step 3: The claim amount will be sent directly to the policyholder’s bank account.
In any emergency situation such as an accident, inform the company within 24 hours of hospitalization. You can inform the company by calling on their toll-free number or by emailing them. Here are a few important points to process these claims:
Step 1: Inform the company and contact the hospital TPA.
Step 2: Download the claim form and fill in all the details and submit it to the TPA or the company.
Step 3: Care Health Insurance Company will settle the claim after verification of the document.
For submitting the accident claims following documents are required:
Here is the list of documents required for filing the claim:
Sometimes the claims get rejected, and there may be many reasons behind this. Here are a few tips that may help you avoid rejection of claims:
Care Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, Care Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
To cater to the different medical needs of an individual & their family, Care 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 Care Health Insurance plans explore more:
Individual and Family Health Insurance
Arogya Sanjeevani was first introduced by IRDAI (Insurance Regulatory and Development Authority of India) in the year 2020 to provide a standard and a...
Unique Features
Individual and Family Health Insurance
Care Operation Insurance Plan is designed specifically to offer you surgical operations coverage. A wide range of sum insured options are available ra...
Unique Features
Individual and Family Health Insurance
Care Advantage Health Insurance is an ideal 1 Crore option so that a policyholder's family is adequately covered. Care Advantage health insurance offe...
Unique Features
Critical Illness Health Insurance
Worried about cancer in your bloodline? Care Cancer Mediclaim has got you covered. Cancer can be defined as distress, hopelessness and loss. There cou...
Unique Features
Accident Health Insurance
Care Secure personal accident policy covers accidental death, permanent and temporary partial/total disability, recovering treatment costs, accidental...
Unique Features
Individual and Family Health Insurance
Care Supreme is an extensive coverage health insurance plan that safeguards you and your family members without worrying about your future healthcare ...
Unique Features
Individual and Family Health Insurance
Free yourself from the worries of healthcare. As the name suggests, Care Freedom is the plan that allows you to be worry-free in every situation. Thi...
Unique Features
Critical Illness Health Insurance
Critical Mediclaim Care health insurance policy gives you protection against 32 defined critical illnesses based on an indemnity plan. This super-faci...
Unique Features
Senior Citizen Health Insurance
Care Senior Citizen is specially designed to offer coverage for individuals above 60 years of age. It offers flexibility to choose the sum insured tha...
Unique Features
Individual and Family Health Insurance
Single health insurance to cover all family members. Care health insurance plan is a comprehensive medical policy for individuals and families. It is ...
Unique Features
Women Health Insurance
An ideal combination of hospitalization and maternity care. Care Joy health insurance is designed specifically for expecting mothers and their newborn...
Unique Features
Family
A top-up plan based on policy deductible principle Care Enhance is a super top-up health insurance plan that provides extra health insurance coverage ...
Unique Features
Family
Get coverage based on your residential zone. Care Classic health insurance is a family floater health plan ideal for married couples, joint families, ...
Unique Features
Individual and Family Health Insurance
Care Plus health insurance is a complete healthcare plan that is loaded with features and protects you and your family. Care Plus offers comprehensive...
Unique Features
Critical Illness Health Insurance
Care Heart is a unique plan launched by Care Health Insurance that provides the flexibility to choose from benefits like Active heart health check-ups...
Unique Features
Know More About Health Insurance Companies
You can download the claim form from the official website of the Care Health Insurance Company. Visit the company’s website, locate the ’Download’ option on the footer of the page, and click on ’Claim form ’ to download it.
In case of emergency hospitalization, the policyholder must inform the company within 24 hours of being admitted to the hospital.
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Bindiya is a seasoned content writer specializing in keeping readers acquainted with the insurance industry, term insurance developments, and life insurance sector shifts. With an experience of 3 years in insurance, Bindiya ensures that her readers stay well informed with the insurance developments and factually correct information.
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