Health Insurance claim settlement ratio is used to determine the company’s ability of settling claims against the number of requested claims in a financial year.. Every year the Insurance Regulatory and Development Authority of India (IRDAI) publishes the claim settlement ratio of every health insurance company in its annual report.
Evaluating the claim settlement ratio before buying a health insurance plan is a good idea as it reflects the efficiency, reliability, and financial health of an insurer.
In this article, we will tell you everything about the claim settlement ratio of Care Health Insurance.
The claim Settlement Ratio of a company refers to the claims settled by a company against the total claims filed during that financial year. For example, if the company settled 90 claims out of 100, the the CSR of the company would be 90%.
The simple formula of calculating the CSR is
(Total Claims Settled)/(Total Reported Claims + Outstanding Claims at the beginning of Year-Outstanding Claims at the End of Year).
As per the IRDAI Annual Report of 2020-21. The Claim Settlement Ratio of Care Health is 100%. The company claims to settle the cashless claims within the time frame of 2 hrs. Until now, the company has settled up to 25 Lakhs+ claims. The figure shocases that the company understands the importance of quick claim settlement and ensures to support you at the time of medical-financial need.
Care Health Insurance works in a very transparent and systematic manner to clear claims. Following is the clain settlemet process of Care Health Insurance.
Case 1: Cashless Claim Procedure
Note: If the cashless claim is rejected, the insured member can initiate the treatment and file for a reimbursement claim after discharge.
Case 2: Reimbursement Claim Procedure
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