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Royal Sundaram Health Insurance Claim Settlement Ratio
The health claim settlement ratio is defined as the proportion of claims an insurance company settles out of the total claims filed during a financial year. A higher claim ratio indicates the company's stronger ability to settle claim requests. Calculated as a percentage, this ratio helps customers compare the reliability of insurance companies. Royal Sundaram Health Insurance has a high claim settlement ratio, making it a reliable choice.
Claim Settlement Ratio of Royal Sundaram Health Insurance
A claim settlement ratio between 75% and 95% is generally considered good. Royal Sundaram Health Insurance boasts a claim settlement ratio of 97.26% (2025), positioning it as a highly suitable option. Established in 2000, the company currently has over 7,000 network hospitals. Royal Sundaram Health Insurance Company is committed to offering a hassle-free claim settlement process. The following section details the types of claim settlement processes available.
Types of Claims by Royal Sundaram Health Insurance Company
Royal Sundaram Health Insurance offers a quick and convenient claim settlement process. Policyholders can file claims for their health policies in two ways:
- Cashless Claim
- Reimbursement Claim
Royal Sundaram Health Insurance Cashless Claims
Royal Sundaram Health Insurance provides a simple, app-based claim process for customer convenience. Policyholders can easily contact the company for claims, submit documents, and check their claim status via the 'M-Chatra' customer app and the official website. Here's how to make Royal Sundaram Health Insurance Cashless Claims:
- Step 1: Visit a Network Hospital and Intimate TPA
To avail of cashless treatment, policyholders must visit a network hospital. The list of network hospitals is available on the company’s website. For planned hospitalization, the TPA must be intimated 72 hours prior to admission. For emergency hospitalization, the TPA needs to be intimated within 24 hours of admission. - Step 2: Submit Authorization Form and Documents
After admission, the customer must fill out the cashless authorization form provided by the hospital and submit it along with all medical documents to the TPA within 3 hours of admission. If additional documents or information are required, the TPA will inform the customer. - Step 3: Understand Policy Exclusions
Policyholders are responsible for expenses not covered by the insurance policy. If the claim is rejected, a letter will be issued to the customer requesting additional documents or information. - Step 4: Claim Approval and Settlement
If the claim is approved by the company, the claim amount will be settled directly with the hospital.
Royal Sundaram Health Insurance Reimbursement Claims
A reimbursement claim involves the customer paying for medical expenses upfront and then requesting reimbursement from the insurer. Upon approval, the claim amount is transferred to the customer's bank account.
Customers can file a reimbursement claim for treatment received at both network and non-network hospitals of Royal Sundaram Health Insurance Company. Here are the steps for the reimbursement claim process:
- Step 1: Undergo Treatment
Undergo treatment at a network or non-network hospital. - Step 2: Submit Documents
Submit all essential documents along with the reimbursement claim form to the TPA/company within 30 days from the date of discharge. - Step 3: Review and Payment
Upon receiving the final documents, Royal Sundaram Health Insurance Company will review them. If the claim is accepted, the payment will be transferred directly to your bank account within 7 days from the date of acceptance. - Step 4: Resubmission if Rejected
If the required medical details are not provided, the claim may be rejected. In such cases, the customer will need to resubmit the correct documents and information to the company.
How to Buy/Renew Royal Sundaram Health Insurance Plans
Buying or renewing a policy from Royal Sundaram Health Insurance is a quick and largely digital process.
How to Buy
Start on the insurer’s website or through a trusted advisor. Compare plans, choose the right sum insured, fill in personal and medical details, and pay online. The policy is issued instantly after verification.
How to Renew
Visit the renewal section, enter your policy number, review coverage, and pay the premium before the due date. Renewing on time helps retain benefits like waiting period continuity, no claim bonus, and uninterrupted coverage.
Conclusion
Royal Sundaram Health Insurance, with a respectable claim settlement ratio of 97.26% for 2025 and a network of over 7,000 hospitals, demonstrates its commitment to providing accessible healthcare solutions. The company’s streamlined app-based claim process, offering both cashless and reimbursement options, aims to alleviate the financial burden during medical emergencies. Understanding the specific timelines and documentation requirements for both claim types is crucial, and Royal Sundaram strives to ensure a swift and efficient claim settlement experience. By prioritizing transparency and customer convenience, Royal Sundaram empowers policyholders to focus on their recovery with peace of mind.
Ready to experience hassle-free health insurance? Explore Royal Sundaram Health Insurance plans today and download the 'M-Chatra' app to manage your policy and claims with ease. Get a free quote now and take the first step towards a healthier, worry-free future!
