Royal Sundaram Health Insurance Claim Settlement Ratio

Health claim settlement ratio is defined as the claims that the insurance company settles in, to the total number of claims filed during the policy term of the financial year. The higher the claim ratio, the more the company's ability to settle the claim requests. The claims settlement ratio is calculated as a percentage, this makes it easier for the customer to compare the reliability of the insurance company in the market.

Claim Settlement Ratio of Royal Sundaram Health Insurance

As a claim ratio between 85% and 95% is considered good, Royal Sundaram Health Insurance has a claim settlement ratio of 95.95% (2021-2022), which makes it one of the most suitable options. Currently, the company has more than 7000 network hospitals. It was formed in the year 2000. Royal Sundaram Health Insurance Company offers a hassle-free claim settlement process. Let us have a look at the types of claims settlement process in the next section.

Health Insurance Claim Settlement Ratio

Types of Claims by Royal Sundaram Health Insurance Company

Royal Sundaram Health Insurance Claim Settlement is a quick and less time taking process, designed for the convenience of the customer, there are two ways a policyholder can claim for health policies they are:

• Cashless Claim
• Reimbursement Claim

Health Insurance Companies

Royal Sundaram Health Insurance Cashless Claims

The company has a simple, app-based claim process to make the customers' experience good. The policyholder can contact the company for a claim, submit their documents, and check their claim status easily on their customer app’M-Chatra’ and on their official website as well. Here is how Royal Sundaram Health Insurance Cashless Claims are made.

Step 1: To avail cashless treatment policyholders must visit the nearest network hospital. The list of network hospitals is available online on the company’s website.In case of a planned hospitalization, the customer can intimate the TPA 72 hours before getting admitted to the hospital. For emergency hospitalization, the TPA needs to be intimated within 24 hours of getting admitted

Step 2: After getting admitted, the customer is required to fill out the cashless authorization form, provided by the hospital and submit it with all medical documents to the TPA within 3 hours of admission.In case more documents or information is required, the TPA will inform the customer.

Step 3: Policyholders must pay for all the other expenses that the insurance policy does not cover. In case the claim is rejected, a letter will be issued to the customer asking for more documents or information required.

Step 4: If the claim is approved by the company the claim amount will be sent directly to the hospital.

Royal Sundaram Health Insurance Reimbursement Claims

A reimbursement claim is one in which the customer pays the medical expenses for his treatment in the hospital and later requests reimbursement against the cost incurred, and later on, approval the money is transferred to the bank account of the customer.

A customer can file a reimbursement claim at both, network and non-network of Royal Sundaram Health Insurance Company. Here are the steps for the reimbursement claim process.

Step 1: Customers can undergo treatment at a network or non-network hospital.

Step 2: The customer needs to submit all the essential documents along with the reimbursement claim form to the TPA/company within 30 days from the date of discharge from the hospital.

Step 3: After receiving the final documents, they will be approved by Royal Sundaram Health Insurance Company. If the claim is accepted, you will receive the payment directly in your bank account, within 7 days from the date of acceptance.

Step 4: If the customer is unable to provide the required medical details, the claims will be rejected. Then the customer has to resubmit the correct documents and information to the company.