Care Health Insurance Claim Settlement

Care Health Insurance offers customized health insurance plans at affordable premium rates. However, their perfect claims procedure that ensures seamless and hassle-free settlement is the main reason for their huge customer base. With Care Health insurance, claims can be processed online with an easy and quick process. The Religare Care Claim Settlement Ratio of 92.93 % makes it one of the best insurance providers in the country.

Care Health Insurance also have a huge network of over 6000 hospitals that provide a cashless treatment facility to their policyholders. They are well-know for their lightning-fast cashless settlement process that settles claims within 2-3 hours. The process for reimbursement claims is also fast, transparent, and simple. The Religare Care Claim Settlement Ratio itself is an evidence of the customer-friendly approach that Care Health Insurance employs for claim settlement.

Religare Care Claim Settlement Ratio

The claim settlement ratio of Religare Health Insurance providers should vary between 80% to 90%. Religare Care Claim Settlement ratio for 2019 and 2018 was 92.93% and 89.69%. 

The ratio shows their efficiency and reliability when it comes to settling claims. A good health claim settlement ratio reflects the speed of the overall process and the efficiency through which an insurer operates. This is the formula to determine the health claim settlement ratio.

Claim Settlement Ratio = (Total Claims Settled)/(Total Reported Claims + Outstanding Claims at the beginning of Year – Outstanding Claims at the End of Year).

Claim Process Of Care Health Insurance

Care Health Insurance provides a perfect claim settlement for all its health insurance plans including the critical illness plans. It also provides a cashless hospitalization facility for its customers. There are two processes of Religare Health Claim Settlement: Cashless and Reimbursement.

1. Claim Process for Cashless Treatment

Here are the steps for the cashless claim process of Care Health Insurance:

• Firstly, you want to get cashless treatment
• You need to inform Care Health Insurance within 24 hours in case of emergency hospitalization and 48 hours before admission in case of planned hospitalization.
•  While going to a network hospital, keep the cashless treatment card or the policy number and member ID.
•  View your card/policy number of the member ID to the insurance desk of the hospital. 
•  You need to correctly fill the pre-authorization form available at the hospital.
•  Update the insurer and fill the pre-authorization form, which is sent to the Care health insurance company.
•  After checking and viewing the claim details received, the Care Health team sends the policyholder and hospital pertaining to the approval or rejection.
• When the request is approved, the medical expenses will be carried by Care Health directly, while in the case of rejection the policyholder needs to settle the expenses.

2. Claim Process For Reimbursement Treatment

Here are the steps of the reimbursement claim process includes the following:

• In the case of planned hospitalization, the Care Health Insurance Company should be notified before 48 hours of admission to the hospital.
•  In case of an emergency, the statement should be given within 24 hours of hospitalization. 
•  A claim form should be filled and submitted with the relevant documents as per the plan’s terms and conditions.
•  After reviewing the documents and claim form details, the letter of approval is given to the policyholder by the claim management team of Care Health to ratify the approval. Within 15 days the amount is paid.
•  In case of rejection, the insured individual is needed to respond to the query put up by the insurer, or the insured will know the reason for the rejection.

Why is Religare Care Claim Settlement Ratio Important?

Here are the reasons why the Religare Care Claim Settlement ratio is important-

• Assures Great Value Products

Religare Care Claim Settlement ratio has always varied between 80 to 90% which reflects that their health insurance products offer a comprehensive and robust financial protection. This is because they offer a variety of health insurance products with maximum coverage and a quick settlement claim process. Moreover, it is best to choose a higher claim settlement ratio to benefit from a health insurance claim.

• Reflects Efficiency

The Religare care claim settlement ratio also shows that Care health insurance is good at settling the claim efficiently. Moreover, Religare Health Insurance provides the claim settlement within a short period.

• Show Reliability

You need to check the claim history before you buy a health insurance plan. Thus, with the Religare Care Claim Settlement ratio, you can also verify your health insurance provider’s credibility.

Benefits of Care Health Insurance

• Promoter Synergies: It is promoted and brings experiences in the field of wellness and healthcare.
• Wide Network: It provides the best treatment at leading network hospitals across the country.
• Settlements: It has a good claim-settlement file, which is quite convenient and customer-friendly.
• No-Claim Bonus: The no-claim bonus plan can go up to a huge 150%.
• Incurred Claim Settlement Ratio: The incurred claim settlement ratio of Care Health Insurance is 55%.

Documents Required For Care Health Insurance Claim

Mentioned below is the list of documents required for filing a Religare Care Claim:

• Original reports of investigation                                                               
• Provide final hospital discharge summary
•  FIR or post-mortem report if happened
• The prescription of Pharmacy bills 
•  Original bills, receipts, and discharge report
•  Indoor case papers and filled claim form
•  Provide original hospital bills and a valid photo ID proof
•  Provide doctor’s report and original consultation notes
•  Bills and receipt of surgeon’s 
•  Test reports of surgeon’s along with attending doctor’s 

Inclusions in Care Health Insurance Claim

• Health check-ups.
• Pre/Post/Domiciliary hospitalization.
• The sum insured of the recharge
• No claim bonus.
• Alternative and daycare treatments.
• Second opinion/consultation
• Room rent

Exclusions in Care Health Insurance Claim

• Any disease within 30 days of policy start.
• Any type of self-inflicted injury.
• Suicidal tendencies.
• Alcohol/substance abuse-related diseases.
• Congenital diseases.
• Infertility/HIV/AIDS.
• War/Nuclear Fallout/Strikes.
• Riot/Revolt/Rebellion/Revolution.

Conclusion

Care Health Insurance offers wide range of sum insured options while giving the flexibility to customize the plan as per customer needs. It offers a seamless online experience for choosing the right health insurance claim, calculating the premium amount, renewing policies online, and tracking claims in just a few clicks. Their insurance plans provide cashless hospitalization, pre-and-post hospitalization cover, daycare treatment, alternative treatment, no claim bonus, annual health check-up, and much more. The Religare Care Claim Settlement Ratio is 92.93% which reflects their speed and efficiency while settling claims.