Question 1

How many claims I can make with IFFCO Tokio plan?

Accepted Answer

There is no maximum limit for claims to be made. Thus, you can make as many claims as you need within the limit of your plan&rsquo;s sum insured.

Question 2

Can the company reject my claim in any case?

Accepted Answer

Yes. The company can reject your claim on various grounds as per the terms and conditions mentioned in the policy.

Question 3

At how many hospitals is the cashless facility available?

Accepted Answer

You can avail cashless treatment at more than 4,000 network hospitals.

Question 4

What documents do I need to present before Iffco Tokio team to request a claim?

Accepted Answer

Here are the documents which need to be submitted to seek a claim:

Duly filled claim form
Certificate from the doctor
Discharge details
Medicine prescriptions
Medical bills
Final receipts from the hospital
Diagnosis reports such as x-ray scan, ECG, etc.

In addition to these, the claim settlement team of Iffco Tokio may ask for some other documents as well.

Question 5

At how many network hospitals does Iffco Tokio provide cashless claim facility to its policyholders?

Accepted Answer

Yes. Iffco Tokio offers cashless claim facility in over 4,000 network hospitals to the policyholders.

Question 6

Within how much time, one should inform the insurer to seek cashless facility or reimbursement of claim in planned and emergency situation?

Accepted Answer

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.

Question 7

How to calculate the Claim Settlement Ratio (CSR) of IFFCO Tokio Health Insurance?

Accepted Answer

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)

Question 8

How to process cashless insurance claim settlement of IFFCO Tokio Health Insurance?

Accepted Answer

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.

Question 9

How to make reimbursement claims under health insurance plans offered by IFFCO Tokio Health Insurance?

Accepted Answer

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.

Question 10

What is the time frame within which the hospitalisation must be reported to IFFCO Tokio Health Insurance?

Accepted Answer

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.

Question 11

What is the Claim Settlement Ratio of IFFCO Tokio Health Insurance?

Accepted Answer

As per the IBAI&rsquo;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.

Question 12

What is the Claim Settlement Ratio (CSR) of IFFCO Tokio Health Insurance?

Accepted Answer

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

City	No of Hospital
Kolkata	125
Jaipur	60
Ghaziabad	31
Lucknow	49
Pune	119
Gurgaon	49
Patna	15

IFFCO Tokio Health Insurance Claim Settlement

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FAQs

How many claims I can make with IFFCO Tokio plan?

Can the company reject my claim in any case?

At how many hospitals is the cashless facility available?

What documents do I need to present before Iffco Tokio team to request a claim?

At how many network hospitals does Iffco Tokio provide cashless claim facility to its policyholders?

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