Aditya Birla Health Insurance Claim Settlement

Aditya Birla Health Insurance settles claims, including the rejection, within 7 working days of receiving necessary documents, but not more than 30 days.

You can claim as many times as possible, but the total claim can’t exceed the sum insured amount under the policy.

The policyholders are required to submit the claim form along with the documents for the reimbursement of the claim not later than 15 days from the date of discharge from the hospital at the nearest branch of Aditya Birla Health Insurance.

Aditya Birla Health Insurance generally settles the claim within 7 working days of the receipt of the last necessary document, but not more than 30 days.

You can use the formula given below to calculate the Claim Settlement Ratio of Aditya Birla Health Insurance. 

Claim Settlement Ratio (CSR)=(Total number of claims received during a financial year)/(Total number of claims settled during a financial year+Outstanding claims at the beginning of the year)

In case of planned hospitalisation, you must inform Aditya Birla Health Insurance within 48 hours of hospitalisation, whereas in case of emergency hospitalisation, the information should be conveyed 3 days prior to hospitalisation. 

To process cashless insurance claim settlement of Aditya Birla Health Insurance is as follows: 

• Approach the network hospital of Aditya Birla Health Insurance 
• Provide the policy number or show Aditya Birla Health Insurance card at the hospital
• The network hospital will submit the pre-authorization form within 48 hours of hospitalisation. 
• Your claim request will be reviewed by the insurance company and the decision will be conveyed to the network hospital
• Once all the formalities have been completed, the insurance company will settle the bill directly at the network hospital. 

Given below is the process to make claim under Aditya Birla Health Insurance:

• Notify Aditya Birla Health Insurance about the treatment required and get hospitalised at a network hospital or a non-network hospital of your choice. 
• After getting treated, payout of your own pocket at the hospital
• Collect all the claim documents from the hospital and submit them to Aditya Birla Health Insurance
• After verifying your documents, Aditya Birla Health Insurance will approve your claim and will you for the treatment availed. Note that you will be informed about the same on your registered phone number or Email ID.

As per the IBAI’s General Insurance Claim Insights Handbook For Policyholders-4th and 5th Edition, the Claim Settlement Ratio of Aditya Birla Health Insurance for the year 2018-19 and 2019-20 93.68% and 70.81% respectively.

The Claim Settlement Ratio of Aditya Birla Health Insurance for the FY 2019-20 is 70.81%.