Care Health Insurance Claim Settlement

The claim settlement ratio of Care Health Insurance is derived by dividing the total claims paid within 30 days by the overall claims paid. Below are the Claim Settlement Ratios for the previous five years:-

When selecting a health insurance company, it is essential to consider a company's claim settlement ratio (CSR) as it is a reliable insurance metric. CSR helps you determine the company's ability to settle claims, which is crucial for you and your dear ones. There are two main reasons why the CSR is important:-[2]

1. Assists in Evaluating Insurance Companies:- When you are buying a health insurance policy, it's important to consider the Claim Settlement Ratio (CSR) of the insurer. CSR is a metric that helps you determine whether an insurer is suitable for you or not. Before making a purchase, you should compare the CSR of different companies to find the one with the highest ratio. The higher the claim settlement ratio of an insurer, the more likely you are to receive a claim in case you need to make one.

2. Displays the Percentage of Claims that the Insurer has Paid Out:- A high claim settlement ratio is an important factor in deciding whether an insurer is dedicated. A high settlement ratio indicates the insurer is more likely to pay out claims when policyholders need them. However, if the insured fails to provide the appropriate documentation, the claim may be rejected, leading to a decrease in the insurer's claim settlement ratio.

If you need to file a claim from Care Health Insurance, please follow the process mentioned below:-

How To File a Claim

Step 1:- Initiation

When you make a medical appointment or have an emergency, contact InsuranceDekho or Care Health Insurance customer support immediately.

• You can contact Care Customer Support at customerfirst@careinsurance.com or give the Care Health Insurance customer service team a call at their toll-free number, 18001024499.[4]

• To reach an InsuranceDekho representative, please call our customer support number 7551196989 or send us an email at support@insurancedekho.com.[5]

Step 2:- Verification

The claim team at Care Health Insurance will check all of your documents when you submit them. If everything is in order, your claim will proceed with processing.

Step 3:- Tracking

You can get in touch with Care Health Insurance's customer service to follow up on your claim. To aid you in receiving frequent updates, you may also get in touch with a customer support agent at InsuranceDekho.

There are two sections to the information that must be completed to submit a claim for Care Health Insurance. The separated information is listed as follows:

Furthermore, the information listed below is also necessary:

1. Duly filled claim form

2. Discharge or daycare summary

3. Final hospital bill

4. Payment receipts

5. Investigation report

6. Pharmacy bills

7. Implant invoice

8. Doctor Prescriptions

9. Consultation Papers

10. Age Proof

11. Indoor Case Paper

12. Copy of cancelled cheque

13. KYC Form

More than 22,900 healthcare establishments offer cashless treatments through Care Health Insurance. Notification of planned procedures at non-network hospitals must reach Care Health Insurance 48 hours in advance, or within 48 hours of the patient being admitted to the hospital in the case of an emergency. Notably, authorization for cashless care at non-network hospitals is contingent upon meeting the requirements outlined in your Care Health Insurance policy as well as the hospital's agreements.

Furthermore, the actions to take in the event of cashless and reimbursement claims are listed below:

Cashless Claims

• Go to the closest network hospital of care health company.

• Approach the front desk to speak with the TPA, or third-party administrator.

• TPA will complete and submit your application to Care Health Insurance on your behalf.

• If everything is authorized, the claim executive will examine the reports and proceed with processing the claim.

• You can begin receiving therapy at the hospital as soon as you receive approval.

• Your insurer and the hospital will settle the bill directly after treatment.

Reimbursement Claims

• Notify Care Health Insurance of your hospital stay (within 48 hours in the event of an emergency, and 48 hours in advance if it is planned).

• Pay your hospital costs in full and turn in all required paperwork.

• Complete and send in a claim form.

• Await the insurer's permission and status report.

Keep in mind that you must:

• Submit all paperwork with your claim form within 15 days of discharge.

• Save all properly signed paperwork for submission to ensure a seamless claim procedure.[3]

Use the procedures listed below to verify the status of your Care Health claim both online and offline:-

Online

• Go to the Care Health Insurance webpage.

• Select the "Already a Customer" option located in the upper right corner.

• Select "Claim Genie" from the options on the tab.

• You'll be taken to the claim page.

• Enter your information to begin the claim procedure.

Offline

• Submit a copy of your insurance document when you visit the Care Health Insurance branch that is closest to you.

• Speak with a branch office executive who can help you by understanding your coverage and the status of your claim.

You can also receive the update by sharing your claim reference number with the customer care executive over the phone at 18001024499, which is a toll-free number, or by calling any number from the list provided on the Care Health Insurance website.

The Insurance Regulatory and Development Authority of India (IRDAI) states that it typically takes an insurer 30 days from the date of payment or the filing of claim documents to settle a claim.

Tips to Get Your Claim Settlement Faster

To expedite the settlement of your claims, bear the following in mind:

• Gain a deeper understanding of your policy.

• Send only completed documents.

• Keep a record of all your correspondence with your insurance.

• Maintain an active policy.

• Examine each paper you have carefully.

• Consult an attorney if necessary.

To get claim assistance and support from Care Health Insurance:[4]

• Call toll-free at 18001024499.

• Email at customerfirst@careinsurance.com

• Whatsapp Care Health Insurance by saying 'Hi' at 8860402452
  
  

To get claim assistance and support from InsuranceDekho you can:[5]

• Email:- support@insurancedekho.com

• Contact No:- +91-755 1196 989.

[1] https://www.careinsurance.com/

[2] https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio

[3] https://www.careinsurance.com/health-insurance-claim-forms.html

[4] https://www.careinsurance.com/contact-us.html

[5] https://www.insurancedekho.com/contact-us