Star Health Claim Settlement Ratio
Purchasing health insurance without researching the company's performance can lead to complications on the occurrence of a medical emergency. The Claim Settlement Ratio is one such factor that you should definitely check when purchasing health insurance.
After all, what good is a health insurance policy if your insurance company can't fulfill your claims on time? Still confused? Do not worry. In this article we have covered everything related to Star Claim Settlement Ratio, and its importance.
Health Insurance Claim Settlement Ratio
What is a Claim Settlement Ratio?
The claim settlement ratio or CSR is the percentage of claims that have been paid by an insurance company. In simpler words, it is the percentage of claims paid out by an insurer during a financial year. The ratio compares the number of claims filed to the number of claims settled.
Health Claim Settlement ratio=the number of claims settled/number of claims received * 100
If you have decided to buy a Health Plan from Star Health then checking Star Health Settlement Ratio might provide you insight into how it's doing in terms of settling claims. It will also give you details about the company's ability to settle claims on time. The higher the claim settling ratio, the more capable the company is settling claims.
Star Health Insurance Claim Settlement Ratio
As per IRDAI, Star Health Claim Ratio is 99.73%. Take a look at the below given table that will let you get an insight into the ability of Star Health Claim Settlement.
|Status of Star Health Claim Settlement ratio- 2020-21|
|Age Analysis of Number of Claims Paid (%)||< 3 months||3 months to 6 months||6 months to <1 year||1 year to <3 year||3 years to <5 years||5 years|
|Claims Settled ||99.64||0.30||0.05||0.01||0.00||0.00|
What is the Claim Process of Star Health Insurance Plans?
The company grants two simple ways to file claims.
Cashless Claim Settlement Process
- The cashless facility is only available at network hospitals of Star Health.
- Reach the insurance desk of the hospital, inform the company and show your health identity card.
- You can download the pre-authorization form from the company’s website. Fill the details and submit the form.
- The form will be submitted to the company and will be processed further for verification.
- The company’s assigned field doctor may visit you (if required).
- On successful verification and acceptance of the claim, the insured can enjoy a cashless treatment facility. All the bills will be looked after by the company.
Health Insurance Companies
Reimbursement Claim Settlement Process
- The reimbursement claim is applicable if the treatment is taken at a non-network hospital or if the cashless claim has been rejected.
- Contact the company within 24 hours of hospitalization.
- Avail treatment, settle all the bills and file a claim for reimbursement.
- Submit the required documents like hospital bills, pharmacy bills, together with all the original documents of treatment and the claim form to the company within 15 days of the discharge.
- The company will verify all the information and process the claim. The confirmation of the same will be communicated to you over call or email.
- If approved, you will receive the reimbursement amount in your registered bank account.
- Completed claim form with necessary details like present address, contact number, and e-mail ID.
- Original bills, receipts, and discharge certificate/card from the hospital.
- Original bills from chemists supported by proper original prescriptions.
- Receipt and investigation test reports from a pathologist supported by the note from the attending medical practitioner/surgeon prescribing the test.
- Nature of operation performed and surgeon's bill and receipt.
- Self-declaration/MLC/FIR in case of accident cases.
- Treating doctor's certificate.
- NEFT and KYC details.
- Others requested by the company.