IFFCO Tokio Health Insurance Claim Settlement

Iffco Tokio General Insurance settled about 8.61 lakh claims in FY 2019 and has a 92.65% health claim settlement ratio. The insurer is a pioneer in the health insurance industry, and it is dedicated to making health insurance claims settlements as simple as possible. Many people seem to miss the insurer’s claim ratio when choosing a health insurance plan.

IFFCO Tokio Health insurance

IFFCO Tokio General Insurance Company is a joint venture between the Indian Farmers Fertiliser Cooperative Limited (IFFCO) and the Tokio Marine Group, with the former holding 51 per cent of the company and the latter holding the remaining 49 per cent. The company, which was founded in 2000, offers a wide range of insurance products, including health insurance, car insurance, motorcycle insurance, travel insurance, home insurance, and corporate policies such as property insurance and liability insurance, to meet the diverse insurance needs of its customers. 

IFFCO Tokio General Insurance Company is dedicated to providing you with peace of mind by offering a variety of comprehensive health insurance options that can be purchased individually or as a floater, covering many relationships. Numerous benefits are included in IFFCO Tokio health insurance policies, including coverage for health check-ups, ambulance fees, pre-hospitalization and post-hospitalization expenses, and so on. Overall, the insurer’s specialised products meet a wide range of needs from various segments of society.

IFFCO Tokio Health Insurance Claim Process

IFFCO Tokio Health Insurance, a pioneer in the health insurance sector, is committed to providing a simple and straightforward health claim process. The insurance offers a smooth claim settlement procedure across the country according to its laws, thanks to a large network of roughly 4,200 network hospitals. IFFCO Tokio is well-known for its simple and quick cashless claim process, which can be done through external TPAs or directly by IFFCO Tokio. Policyholders can choose between a refund option or a cashless facility to settle their claims.

Claim Process for Cashless Treatment

Cashless claims are only available in IFFCO Tokio’s network hospitals. Currently, the insurance has over 4,200 hospitals on its books. However, the following is a step-by-step instruction to making a cashless claim with IFFCO Tokio:

• Look for an IFFCO Tokio-affiliated hospital where you can get cashless treatment. 
• In the case of emergency hospitalisation, notify the Third Party Administrator (TPA) right away, and in the case of planned admission, notify the TPA three days in advance.
• Find a cashless request form at the hospital’s assistance desk, fill it out, and email it to the TPA along with medical data. 
• The TPA will notify the hospitals of its decision, which could include approval of the claim or a request for more information. 
• If the TPA approves a cashless claim, medical costs will be paid directly according to the policy’s provisions.
• If the TPA rejects the claim, the policyholder will be responsible for paying the bill directly to the hospital and then requesting reimbursement according to the terms and conditions.

Reimbursement Treatment

If for some reason a person is unable to use the cashless treatment facility at a network hospital and must be treated at a non-network hospital, the reimbursement procedure sets in. The procedure is as follows:

• Notify IFFCO-Tokio about the hospitalisation as soon as possible following the hospitalisation, but no later than 7 days after release. 
• Please mention your Policy Certificate Number when informing others. 
• Choose a medical therapy or procedure and take advantage of it. 
• Pay the hospital costs and submit the reimbursement claim. 
• The refund claim form can be downloaded from the insurer’s website.
• At the time of discharge, gather all supporting documents such as medical reports, invoices, ID proof, and so on, and submit them to the insurer’s office along with the claim form.

Documents Required for Filing a Claim

List of documents needed for smooth and easy filing of claim at IFFCO Tokio Health Insurance:

• Claim form with doctor’s certificate 
•  Discharge details 
•  Medical bills
•  Prescriptions for medicines
•  Final receipts
•  Test reports of diagnosis, x-ray scan, ECG etc.

IFFCO Tokio Health Insurance Claim Settlement Ratio

The Claim Settlement Ratio is a percentage of the total number of health insurance claims received by an insurance provider during a financial year divided by the number of claims settled. The Claim Settlement Ratio (CSR) of IFFCO Tokio for FY 2019-20 is 96.33%.

Reviews and Ratings

The policy has an impressive rating of 4.6/5 based on 27 reviews from Policy Bazaar. Insurance Dekho has given the policy a rating of 4.3/5 based on 76 reviews. 

Nitesh – At the time of discharge, gather all supporting documents such as medical reports, invoices, ID proof, and so on, and submit them to the insurer’s office along with the claim form.

Ashok – At the time of discharge, gather all supporting documents such as medical reports, invoices, ID proof, and so on, and submit them to the insurer’s office along with the claim form.