Claim Settlement of Aditya Birla Health Insurance
Aditya Birla Capital lets you have a seamless experience in filing claims. With a strong presence in the health insurance domain in India, the insurer believes in speedy and efficient claim settlement service. That’s why, it has established a claim settlement team, which helps customers get insurance claims settled in an easy and convenient way. As a trusted name in the insurance space, Aditya Birla provides two ways to settle claims viz Cashless and Reimbursement.
Claim Process for Cashless Treatment
With Aditya Birla Capital Health Insurance, you can avail the benefit of cashless treatment at more than 5,600+ network hospitals anywhere in the country. The procedure to file a claim is as follows:
- First, search for an Aditya Birla network hospital in the city where you want to get cashless treatment
- Intimate Aditya Birla within 48 hours (emergency hospitalisation) and 3 days before admission in case of planned hospitalisation.
- While visiting the hospital, carry the patient’s Aditya Birla Health Insurance cashless card or the policy details.
- Show the Health Insurance cashless card and valid ID proof at the insurance desk of the hospital.
- Fill in the pre-authorization request form correctly available at the hospital and submit it to the hospital.
- For quicker action, fill the request form on the official website and intimate the insurer.
- Wait for the decision as your request will be reviewed.
- Aditya Birla Capital Health Insurance may take up to 2 hours after receiving the request and will inform about the decision via an e-mail and an SMS. You can also check the status online.
- The claim will be processed as per the terms and conditions of the policy after all the formalities are completed.
In case your claim request for cashless hospitalisation gets rejected, or if you have availed treatment at a non-network hospital, then you can claim for reimbursement for the expenses incurred. Know the process below.
- Notify Aditya Birla within 48 hours in case of emergency hospitalisation. In case of planned hospitalisation, a notification has to be sent 3 days before admission in a network or non-network hospital.
- Collect the relevant documents mentioned below from the hospital and submit it to Aditya Birla Capital Health Insurance within 15 days of discharge from the hospital.
- The company will review and take a decision accordingly.
- If the request is approved, you will get the approved amount through NEFT.
- In other cases, all the communication will be done on your registered e-mail address and contact number.
The following documents have to be sent at the health insurance claim office of Aditya Birla Capital Health Insurance-
- Original investigation reports
- Final hospital discharge summary
- FIR or post-mortem report if happened
- Pharmacy bills along with the prescription
- Canceled cheque or NEFT details for payment
- Original bills, receipts, and discharge report
- Indoor case papers and duly-filled claim form
- Original hospital bills and a valid photo ID proof
- Treating doctor's report, and original consultation notes
- Nature of operation performed and surgeon's bill and receipt
- Test reports along with attending doctor’s or surgeon’s report
To clear any doubt, get in touch with InsuranceDekho at 1800-1205-698.
Incurred Claim Ratio (ICR) of Aditya Birla Health Insurance
Incurred Claim Ratio is an important factor that helps shortlist a health insurance plan. It indicates the health insurance company’s ability to pay the claims. Every year IRDAI (Insurance Regulatory and Development Authority) publishes data of the ICR in its annual report. The ICR Aditya Birla Capital Health Insurance is 59%.