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Liberty Health Insurance Claim Settlement

For the fiscal year 2019-20, the Liberty health insurance claim settlement percentage is 94 per cent. Liberty General Insurance (LGI) is known for settling claims quickly and smoothly. The claim ratio reflects the ability of the insurance provider to process your claims. You can pay your health insurance claims with Liberty General Insurance using both cashless and reimbursement processes.

Liberty Health insurance

Liberty General Insurance Limited is a joint venture between US-based Liberty Mutual Insurance Group, Liberty Citystate Holdings PTE Limited, Enam Securities, a privately owned and managed institution that makes long-term investments in listed firms, and the DP Jindal Group, an industrial conglomerate. Since its inception in 2013, Liberty General Insurance has been able to provide a wide range of insurance services in India, including health and personal accident insurance, employee compensation insurance, car and two-wheeler insurance, commercial insurance, fire and engineering insurance, marine insurance, and other miscellaneous insurance services.

The insurance company employs approximately 1,200 people over a network of 97 offices in 95 locations across 28 Indian states. It also has a network of over 5000 hospitals where its insured can get cashless services. The insurer obtains a variety of health insurance solutions for people, families, and corporations when it comes to health care offerings. Several awards have been given to the company throughout the years for its constant and exceptional performance. Model Insurer Asia – Digital and Omnichannel award 2017, Most Influential Retail Leaders – CMO ASIA, Digital Transformation Award 2016.

Liberty Health Insurance Claim Process

With the support of its designated Vipul Med Corp TPA, Liberty General Insurance (LGI) is devoted to providing a swift and easy claims process. With nearly 4,000 hospitals in its network, the firm settles claims according to the terms of the policy. LGI is committed to not just resolving claims as quickly as possible, but also to assisting consumers and standing by their side when they require assistance. You have the option of having your claim settled through a cashless or reimbursement method.

Claim Process for Cashless Treatment

If you receive treatment at one of Liberty General Insurance’s network hospitals, you will be eligible for cashless procedure benefits. You won’t have to pay any medical fees during this process because the insurer will cover them.  

  • Approach one of your city’s network hospitals. 
  • At least 48 hours before a planned hospitalisation, have an intimate TPA. In the event of an emergency, notify the TPA within 24 hours of being admitted to the hospital. 
  • Carry your “Liberty Health Card” or provide the hospital with your “Policy Number” and a valid photo ID. 
  • Pick up a pre-authorization request form from the hospital.
  • Fill it and give it to the hospital administration. 
  • The hospital/TPA delivers the paperwork to Liberty General Insurance, which reviews the documentation and categorises the case as Authorized, Queried, or Denied after verifying your identity. 
  • They send an e-mail confirmation to the Network Hospital, as well as a text message and an e-mail to you, confirming the same. 
  • Then they settle the claim with the hospital.

Reimbursement Treatment

If you receive treatment at a hospital that is not part of the insurer’s network, you must file a reimbursement claim. In this instance, you settle the hospital’s medical care fees before filing a reimbursement claim with TPA. Here’s how to file a reimbursement claim in its entirety.

  • Intimate TPA at least 48 hours before the planned hospitalisation.
  • In an emergency, notify the TPA within 24 hours of being admitted to the hospital. 
  • Get the care you need at the hospital of your choice and pay all of your costs. 
  • At the time of discharge, gather original medical bills, examination reports, receipts, Medical store bills.
  • Fill out the reimbursement claim form available on LGI’s official website. 
  • Send all of the paperwork to the TPA by mail or courier within 15 days. 
  • LGI examines the claim reports and may request more documents if necessary. 
  • The claim is either allowed or refused after all of the details have been verified. 
  • If your claim is approved, the funds are transferred to your bank account. 

Documents Required for Filing a Claim

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

  • Duly completed claim form
  •  Medical case history/summary
  •  Original investigation reports and bills
  •  The original receipt and discharge summary
  •  Original cash memos from the hospital, chemist, etc. 
  •  Pharmacy bills along with the proper prescriptions
  •  Medical practitioner/surgeon’s original bill and receipt
  •  Original bills & receipts for claiming ambulance charges
  •  The surgeon’s certificate stating the nature of operation performed
  •  Certificate of the attending doctor/consultant/anaesthetist regarding diagnosis
  •  Other reports or pathological tests supported by surgeons demanding such pathological tests
  •  Any other documents, as may be necessary by the Company or TPA  

Liberty 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 Liberty General Insurance for FY 2019-20 is 81.03%. 

Reviews and Ratings

The policy has an impressive rating of 4.3/5 based on 22 reviews from Policy Bazaar. Insurance Dekho has given the policy a rating of 4.2/5 based on 59 reviews.

Rajkamal – The claim ratio is very good and that is why I choose this company. Many of my friends got their clearance ready easily. 

Simi – I purchase this policy in 2019 and from that time they always assist mail us the new notifications. Very good company.

FAQs

How much time in advance should I inform the company to seek cashless facilities in a planned and emergency situations?

You must notify the company within 48 hours and 24 hours of hospitalisation, respectively, to use the cashless facility in a scheduled or emergency circumstance.

What is the maximum number of claims that can be made within a policy year?

You can make any number of claims till a specific cap is prescribed to you under the plan