Q: What is the Claim Settlement Ratio of National Insurance?

According to the IBAI’s General Insurance Claim Insights Handbook For Policyholders-5th Edition, the Claim Settlement Ratio of National Insurance for the financial year 2019-20 is 83.78%.

Question 1

When should I inform the company in case of planned hospitalisation for reimbursement of the treatment?

Accepted Answer

You must inform the company at least 72 hours before the admission in case of planned  hospitalisation  to get reimbursement for the treatment.

Question 2

In how many ways does National Insurance settles claims?

Accepted Answer

National Insurance settles claims in two different ways. These are-cashless and reimbursement.

Question 3

In how many hospitals can I enjoy a cashless treatment with National Insurance?

Accepted Answer

National Insurance has over 6,000 network hospitals across India, where the policyholders can seek cashless treatment.

Question 4

What are the documents required for claim settlement with National Insurance?

Accepted Answer

National Insurance requires the following documents for the claim settlement-        	 Duly filled claim form   	 Relevant cash memos and prescriptions   	 Certificate of diagnosis from the attending medical practitioner   	 Payment receipt in original along with the attending medical practitioner&rsquo;s reports   	 Any other related documents as asked either by the company or the TPA

Question 5

How to calculate the Claim Settlement Ratio (CSR) of National Insurance?

Accepted Answer

Claim Settlement Ratio of National Insurance can be calculated using the formula given below:    Claim Settlement Ratio = (Total no. of claims approved/Total no. of claims received) x 100

Question 6

How to process cashless insurance claim settlement of National Insurance?

Accepted Answer

To process cashless insurance claim under National Insurance plans, you must follow the steps given below:       Inform the National Insurance Company about the hospitalisation, before 72 hours in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.     Get a cashless claim request form from the insurance company or the insurance provider and submit it to the concerned person at the hospital. The hospital authorities will share the documents with the insurer.     Your documents will be verified along with the pre-authorisation form.     On the basis of documents submitted, the insurance company will make a decision on whether to accept or reject the claim request.     The network hospital will then send the final request and settle the bills at the network hospital.

Question 7

How to make reimbursement claims under health insurance plans offered by National Insurance?

Accepted Answer

To make reimbursement claims under health insurance plans offered by the National Insurance Company, you must follow the steps given below:       Intimate National Insurance Company about the hospitalisation, before 72 hours in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.     Avail the required medical treatment and settle the bills out of your own pocket. Collect the documents related to your treatment, when leaving the hospital.    Submit the duly filled request form along with relevant documents to the insurance company.    Your documents will be verified by the insurance company and if the claim is made in accordance with the terms and conditions of your health insurance policy, then the company will pay you for the expenses incurred for the treatment.

Question 8

What is the time frame within which the hospitalisation must be reported to National Insurance?

Accepted Answer

In case of a claim under National Insurance plan, you are required to inform National Insurance Company 72 hours in advance in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.

Question 9

What is the Claim Settlement Ratio of National Insurance?

Accepted Answer

According to the IBAI&rsquo;s General Insurance Claim Insights Handbook For Policyholders-5th Edition, the Claim Settlement Ratio of National Insurance for the financial year 2019-20 is 83.78%.

Question 10

What is the Claim Settlement Ratio of National Insurance?

Accepted Answer

As per the IRDAI (Insurance Regulatory and Development Authority of India), the Claim Settlement Ratio of National Insurance for FY 2019-20 is 83.78%.

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FAQs

When should I inform the company in case of planned hospitalisation for reimbursement of the treatment?

In how many ways does National Insurance settles claims?

In how many hospitals can I enjoy a cashless treatment with National Insurance?

What are the documents required for claim settlement with National Insurance?

How to calculate the Claim Settlement Ratio (CSR) of National Insurance?

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