Q: What is the Claim Settlement Ratio of Aditya Birla Health Insurance?

As per the IBAI’s General Insurance Claim Insights Handbook For Policyholders-4th and 5th Edition, the Claim Settlement Ratio of Aditya Birla Health Insurance for the year 2018-19 and 2019-20 93.68% and 70.81% respectively.

Question 1

When should a reimbursement claim request be submitted?

Accepted Answer

Request for reimbursement claim should be submitted within 15 days of getting a discharge from the hospital or clinic.

Question 2

What is the period in which Aditya Birla Health Insurance settles claims?

Accepted Answer

Aditya Birla Health Insurance settles claims, including the rejection, within 7 working days of receiving necessary documents, but not more than 30 days.

Question 3

Is there any limit for the number of claims that can be made in a year?

Accepted Answer

You can claim as many times as possible, but the total claim can&rsquo;t exceed the sum insured amount under the policy.

Question 4

Where can I submit my claim documents?

Accepted Answer

The policyholders are required to submit the claim form along with the documents for the reimbursement of the claim not later than 15 days from the date of discharge from the hospital at the nearest branch of Aditya Birla Health Insurance.

Question 5

In how much time Aditya Birla Health Insurance settles the claim?

Accepted Answer

Aditya Birla Health Insurance generally settles the claim within 7 working days of the receipt of the last necessary document, but not more than 30 days.

Question 6

How to calculate the Claim Settlement Ratio (CSR) of Aditya Birla Health Insurance?

Accepted Answer

You can use the formula given below to calculate the Claim Settlement Ratio of Aditya Birla Health Insurance.     Claim Settlement Ratio (CSR)=(Total number of claims received during a financial year)/(Total number of claims settled during a financial year+Outstanding claims at the beginning of the year)

Question 7

What is the time frame within which the hospitalisation must be reported to Aditya Birla Health Insurance?

Accepted Answer

In case of planned hospitalisation, you must inform Aditya Birla Health Insurance within 48 hours of hospitalisation, whereas in case of emergency hospitalisation, the information should be conveyed 3 days prior to hospitalisation.

Question 8

How to process cashless insurance claim settlement of Aditya Birla Health Insurance?

Accepted Answer

To process cashless insurance claim settlement of Aditya Birla Health Insurance is as follows:        Approach the network hospital of Aditya Birla Health Insurance     Provide the policy number or show Aditya Birla Health Insurance card at the hospital    The network hospital will submit the pre-authorization form within 48 hours of hospitalisation.     Your claim request will be reviewed by the insurance company and the decision will be conveyed to the network hospital    Once all the formalities have been completed, the insurance company will settle the bill directly at the network hospital.

Question 9

How to make reimbursement claims under health insurance plans offered by Aditya Birla Health Insurance?

Accepted Answer

Given below is the process to make claim under Aditya Birla Health Insurance:       Notify Aditya Birla Health Insurance about the treatment required and get hospitalised at a network hospital or a non-network hospital of your choice.     After getting treated, payout of your own pocket at the hospital    Collect all the claim documents from the hospital and submit them to Aditya Birla Health Insurance    After verifying your documents, Aditya Birla Health Insurance will approve your claim and will you for the treatment availed. Note that you will be informed about the same on your registered phone number or Email ID.

Question 10

What is the Claim Settlement Ratio of Aditya Birla Health Insurance?

Accepted Answer

As per the IBAI&rsquo;s General Insurance Claim Insights Handbook For Policyholders-4th and 5th Edition, the Claim Settlement Ratio of Aditya Birla Health Insurance for the year 2018-19 and 2019-20 93.68% and 70.81% respectively.

Question 11

What is Aditya Birla Health Insurance's Claim Settlement Ratio for the financial year 2019-20?

Accepted Answer

The Claim Settlement Ratio of Aditya Birla Health Insurance for the FY 2019-20 is 70.81%.

City	No of Hospital
Indore	46
New Delhi	6
Nagpur	70
Pune	167
Ahmedabad	70
Patna	47
Surat	52

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FAQs

When should a reimbursement claim request be submitted?

What is the period in which Aditya Birla Health Insurance settles claims?

Is there any limit for the number of claims that can be made in a year?

Where can I submit my claim documents?

In how much time Aditya Birla Health Insurance settles the claim?

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