Aditya Birla Health Insurance Claim Settlement
Aditya Birla Health Insurance 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 is why, it has established an Aditya Birla Health Insurance 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 Health Insurance Claim Settlement, you can avail the benefit of cashless treatment at more than 6,000+ 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 out the request form on the official website and inform 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 you 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.
How to Check Aditya Birla Health Insurance Policy Claim Status
You can check your claim status either online or offline.
You can check your claim status by following the given steps:
- You need to visit the official website of Aditya Birla Health Insurance Company. Thereafter, go to the claim status portal.
- Login to the portal using username and password. Then, from there you can track your claim status.
If you are unable to track your claim status request through an online portal, then you can directly contact them at their helpline number 1800-270-7000. You can also visit the nearest branch of Aditya Birla Health Insurance Company and ask the customer care representative for the same. They may ask you for information like your policy intimation number, Policy ID card number, etc to provide you with further updates regarding your policy.
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 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 hospital or non-network hospital.
- Collect the relevant documents mentioned below from the hospital and submit them to Aditya Birla Capital Health Insurance within 15 days of discharge from the hospital.
- Submit the duly filled reimbursement claim form along with other necessary documents.
- The company will review and make 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 to the health insurance claim office of Aditya Birla Capital Health Insurance-
- Original investigation reports
- Final hospital discharge summary
- FIR or post-mortem report it 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 the customer care executives at InsuranceDekho on the toll-free number 7551-196-989.
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 of Aditya Birla Health Insurance Claim Settlement Ratio for FY 2018-19 is 59%.
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Aditya Birla Health Insurance Claim Settlement FAQs
When should a reimbursement claim request be submitted?
Request for reimbursement claim should be submitted within 15 days of getting a discharge from the hospital or clinic.
What is the period in which Aditya Birla Health Insurance settles claims?
Aditya Birla Health Insurance settles claims, including the rejection, within 7 working days of receiving necessary documents, but not more than 30 days.
Is there any limit for the number of claims that can be made in a year?
You can claim as many times as possible, but the total claim can’t exceed the sum insured amount under the policy.
Where can I submit my claim documents?
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.
In how much time Aditya Birla Health Insurance settles the claim?
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.
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