All You Need to Know About Filing a Claim with Star Health Insurance
Updated On Sep 08, 2021
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One of the deciding considerations of health insurance is a regular claim settlement ratio that shows an insurer's willingness to keep its clients happy. There are many insurers who, when it comes to paying a claim, stand exceptional in terms of their punctuality, who even brag about getting a sound CSR. Star Health Insurance is one such insurer.
Options to File a Star Health Insurance Claim
There different ways to claim with Star Health Insurance which are
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Cashless
Network clinics are the ones where, under a health care contract, cashless treatment will be used. The bills produced in such situations are sent to Star, and there is no need for the policyholder or the applicant to pay anything.
Procedure to File a Claim
1. The insured must carry his/her member card/policy number and it must be given at the network hospital.
2. In the event of an emergency or expected hospitalisation, call 18004252255 / 18001024477 and fax the pre-authorisation form to 18004255522.
3. One will have to provide the insurance counter of the hospital with personal information and account ID/member ID and fill up the customer's section of the pre-authorisation form.
4. The pre-authorisation form will be faxed to Star after the balance details are filled in by the hospital.
5. The insurer should be told 24 hours before being admitted to the hospital in the event of a planned hospitalisation.
6. The insurer must be notified within 24 hours of being admitted in the event of emergency hospitalization.
7. In the event of acceptance, awaiting approval or denial, the Star in-house medical staff will review the case and records obtained and notify the guardian and hospital.
8. In the case of awaiting acceptance cases, Star will notify the hospital to provide further information and a claim reimbursement procedure has to be pursued in cases of denial.
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Reimbursement of Treatment Expenses
Reimbursements may be preferred for treatments undertaken in hospitals, not within the Star Health Insurance network, and treatments not accepted for the cashless mode. In such instances, the following procedure would need to be implemented.
1. The following will be the information needed during this process.
- Name of policyholder
- Name and customer ID
- The hospital details
- Diagnosis and treatment details
- An estimate of the sum of the claim
- Day of admittance
2. Set of all the relevant hospital records to be carried out
Documents Required For Star Health Insurance Claims
The claim form can be accessed from Star Health Insurance’s website and the following documents must be given together with the completed form.
1. The original, fully completed, and properly signed copy of the claim form
2. Valid photo ID proof accepted by the government
3. Health practitioner's recommendation letter advising on hospitalisation
4. Medical practitioner's letter outlining the list of examinations, drugs, and appointments, if any,
5. Initial scans of hospital/private practitioners' bills, receipts, and discharge cards
6. Initial copies of bills or receipts from pharmacies/pharmacists
7. Initial copies of assessments and records, along with receipts of payments
8. Case Papers
9. The FIR and the final police report, where necessary,
10. Initial copy, if performed, of the post mortem examination
The above list of documents is a minimum necessity. As and when required, Star Health could need additional documents. The list of documents referred to above must be submitted by post to the Star Health Insurance address
Conclusion
Well, no claim procedure, regardless of how popular the insurer is, is simple. The primary advantage of Star health insurance is that your claimed balance can be settled quicker. Star Health Insurance has a record of settling cases very quickly in this situation.
Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.
