Customers can check the claim settlement ratio of a health insurance company to understand how the health insurer will handle their claims. A company's ability to settle the claims it receives can be determined by its relevant health claim settlement ratio. The Insurance Regulatory and Development Authority of India (IRDAI) releases the claim settlement ratio for each health insurance provider annually in its annual report.
In the below sections, you will get information regarding the claim settlement ratio of care health insurance.
What is Claim Settlement Ratio?
The Claim Settlement Ratio is a metric used to rate health insurance providers. The number of claims settled by a health insurance company is calculated as a percentage with respect to the total number of claims filed in a year. It helps customers to compare health insurance companies based on health insurance claim settlement ratio and choose the best option as per their requirements. Additionally, the high claim settlement ratio for health insurance ensures high chances of quick settlement of your claims. Hence, before choosing a health insurance policy, it is wise to ensure that your health insurance company has a good claim settlement ratio.
Every year IRDAI (Insurance Regulatory and Development Authority of India) publishes the claim settlement ratio in its annual report in the first month of every year. It helps you evaluate the claim settlement ratio of all the health insurance companies in India.
Care Health Insurance Claim Settlement Ratio
As per the IRDAI (Insurance Regulatory and Development Authority of India) annual report, the claim settlement ratio of care health insurance is 100%. Look at the table below to understand the care health insurance claim settlement ratio:
| Status of Care Health Claim Settlement ratio- 2021-22 | ||||||
|---|---|---|---|---|---|---|
| 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 | 100 | 0 | 0 | 0 | 0 | 0 |
Network Hospitals
Care Health Insurance Claim Process
Care Health Insurance provides a quick and hassle-free claim settlement process. Below mentioned is the claim settlement process for Care Health Insurance:
Cashless Claim Process
- Notify Care Health Insurance within 24 hours of hospitalization or 48 hours in the event of an emergency or planned hospitalization.
- The policy nominee needs to fill and submit the pre-authorization form at the Insurance/TPA desk of the hospital.
- The hospital will send all documentation to Care Health Insurance for verification.
- After verifying all your documents, the Care Health Insurance claims team will send an approval letter to the hospital.
- The hospital will proceed with the cashless treatment of the insured member.
Reimbursement Claim
- Intimate the care health insurance within 48hr of hospitalization (24 hr in case of emergency).
- Submit the claim form to the care health insurance along with other relevant documents such as ID Proof, Original bills, Indoor case paper, etc.
- The claim management team of the care health insurance company will verify the documents.
- Once the verification is done, the care health insurance company will send the claim approval letter to the policyholder.
- After 15 days, the claim amount will be reimbursed to your bank account.
