TATA AIG Claim Settlement Ratio
  • Importance of CSR
  • 90.08% claims settled by TATA AIG
  • Explore the Cashless Claim Process
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TATA AIG Claim Settlement Ratio

Checking the claim settlement ratio before buying health insurance is an important factor that cannot be neglected. Just like when you buy a house, you verify each and every detail like, checking the history of the builder, the projects they had delivered and much more. Likewise, when buying Health Insurance it is imperative for you to check all the details including the claim settlement ratio.

Buying Health insurance from a company that is not able to settle your claims on time is not good for anything. You and your loved ones might face the financial burden, along with the medical strain if your insurance company is unable to settle the claims on time. Thus, before buying health insurance, ensure to check the company thoroughly, evaluate its past performance and then make your final decision.

In the article below, we will be elaborately discussing the TATA AIG Health Insurance claim settlement ratio and its benefits.

Claim Settlement Ratio determines the claim settling ability of an insurance company and is used to rate the company on the basis of its claim settlement. The higher the percentage, the better the company’s ability to settle claims. As per the IRDAI, the claim settlement ratio of TATA AIG Health Insurance is 90.78%

Take a look at the below table that will give you a better idea of the TATA AIG Health Insurance claim settlement ratio from the financial year 2028 to 2021

Health Insurance Claim Settlement Ratio

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Status of TATA AIG Health Insurance Claim Settlement Ratio

Financial Year 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 90.78 4.97 3.36 0.80 0.06 0.04
Financial Year 2019-20
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 92.82 5.30 1.31 0.45 0.07 0.04
Financial Year 2018-19
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 95.1 3.0 1.3 0.5 0.01 0.00

Claim Process of TATA AIG Health Insurance Plans

Now, as you have understood what is CSR and what is the TATA AIG claim settlement ratio 2021, you also need to understand the claim settling process. There are two types of claim processes: Cashless and Reimbursement.

Read below to understand them better.

Cashless Claims:

The cashless claim process is as follows:

  • In case of the need of a treatment, get admitted to one of the network hospitals empanelled with Tata AIG. You can check the list of network hospitals on the company’s website.
  • Validate your identity with the network hospital, after which the hospital will submit the pre-authorization request form to the company.
  • Then the company will review your request and confirm the network hospital by email and a copy of the same will also be shared with you.
  • The company will settle the claim with the hospital after the completion of all the formalities.

Note- In case of emergency hospitalization, you need to inform the insurer within 24 hours. In case of planned hospitalization, you need to inform the insurer at least 5 days in advance.

Reimbursement Claim

In the reimbursement claim process, you need to pay all the treatment bills to the hospital and then get the amount reimbursed from your insurance provider.

  • You can file for reimbursement under TATA AIG health insurance. To do that, the insured must collect all bills, and prescriptions related to the treatment and submit the same along with the claim form to the insurance company or TPA.
  • The insurer will analyze your claim and might ask for additional documents (if required).
  • If it gets approved, the company will transfer the amount directly into your account and in case of rejection, you will receive the reason for the same.

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Reviewed By : Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.