IFFCO Tokio Health Insurance Claim Settlement

The insurer is required to be conveyed within 3 days prior to the hospitalisation in the case of planned hospitalisation. But, in the case of emergency hospitalisation, the insurance providing company need to be informed as soon as an insured member is admitted in the hospital.  

To calculate the Claim Settlement Ratio of IFFCO Tokio Health Insurance, you can use the formula given below: 

Claim Settlement Ratio=(Total claims settled or paid)/(Total claims received+Outstanding claims at the beginning of the year)

To process cashless claims under IFFCO Tokio Health Insurance plans, you are required to follow the steps given below: 

• Get hospitalised at the network hospital of your choice, show your health card at the hospital, and intimate the Third Party Administrator (TPA)
• Fill the cashless claim form and send it by fax to the TPA
• The TPA will examine your document and inform the network hospital about the decision
• The TPA will approve your request and settle the bill directly at the hospital if the claim made was in accordance with the terms and conditions under the policy.

You can make reimbursement claims under IFFCO Tokio health Insurance plans by following the steps given below: 

• On getting hospitalised at a non-network hospital, immediately inform IFFCO-Tokio General Insurance 
• Avail the treatment and pay for the hospital bills from your own pocket
• Download and fill the claim form from the official website of IFFCO Tokio General Insurance 
• Submit the required documents at the IFFCO Tokio office
• The insurance company will settle the bills if the documents are found authentic and the claim has been made as per the terms and conditions under the policy.

You must inform IFFCO Tokio General Insurance within 24 hours of hospitalisation in case of emergency hospitalisation and 48 hours before admission in case of planned hospitalisation. 

As per the IBAI’s General Insurance Claim Insights Handbook For Policyholders-4th and 5th Edition, the Claim Settlement Ratio (CSR) of IFFCO Tokio Health Insurance for the financial years 2018-19 and 2019-20 is 96.57% and 96.33% respectively.  

The Claim Settlement Ratio (CSR) of IFFCO Tokio for FY 2019-20 is 96.33%.