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Bajaj Allianz Health Insurance Claim Settlement

The claim settlement process of Bajaj Allianz is comparably hassle-free. With thousands of hospitals in its list of networked healthcare centers, this insurance company entertains policyholders with easy reimbursement and cashless claim settlement processes in listed hospitals across India. Moreover, Bajaj Allianz offers a wide range of health insurance policies at affordable prices and makes your life simpler during a stressful situation or a medical emergency.

  • Claim Process for Cashless Treatment

    Cashless treatment gets you treated for a particular illness without paying even a single penny for any medical expense. You can avail cashless treatment at any of the network hospitals in India. Currently, Bajaj Allianz has more than 6,000 hospitals in its network list. Find guides for the cashless claim process:

    • First of all, find a Bajaj Allianz network hospital in a city where you want to get cashless treatment
    • Intimate the insurer about your hospitalisation as soon as possible - whether it's an emergency or planned.
    • While visiting the hospital, don't fail to carry the Bajaj Allianz cashless card and one photo ID proof.
    • Show the cashless card and valid ID proof at the hospital desk.
    • Fill out the pre-authorization request form available at the hospital and submit it to the hospital.
    • After your identity is checked, the network hospital sends the pre-authorization request form to Bajaj Allianz-HAT (Pune) after verifying your details.
    • Bajaj Allianz reviews the request details in accordance with the policy benefits and conveys the decision to the hospital and the insured.
    • Once the claim is approved, the hospital begins the cashless treatment.
    • In case of denial of the request, you can get the treatment and file for reimbursement claim later.

    How to Check Bajaj Allianz Health Insurance Plan Claim Status

    You can track your Bajaj Allianz Health Insurance Plan claim status online or offline.

    Online Procedure

    To check your claim status follow the given steps:

    • Visit the official website of Bajaj Allianz.
    • Go to their General Insurance Claim system.
    • Upload the necessary documents along with details on the system.
    • Track the status of your claim instantly.

    Offline Procedure

    If you cannot track your claim status online, you can simply call the customer care representative at 1800-103-5858 and tell them about your claim reference number. You can also visit the nearest branch.

  • Reimbursement Treatment

    Need not worry if your request for cashless claim didn’t get approved, or if you did not get admitted to a network hospital. In both cases, you can file for a reimbursement claim. Follow the below instructions to file for the reimbursement claim.

    • Submit the duly filled reimbursement claim form to Bajaj Allianz.
    • Submit all original medical (pre-hositalisation and post-hospitalisation) documents..
    • You will receive an approval letter after thorough verification of the documents submitted.
    • In case of a requirement, Bajaj Allianz can ask for additional documents.
    • If the claim approved, the payment will be released to the insured through ECS/cheque.
    • If the relevant documents are not submitted, then the claim will be closed without any payment after 45 days.
  • Documents Needed

    Here is a list of documents required for filing a reimbursement claim settlement:

    • 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
  • Incurred Claim Ratio (ICR) of Bajaj Allianz Health Insurance

    The Incurred Claims Ratio (ICR) indicates the performance of an organization, thereby helping customers make an informed decision when choosing a health insurance policy. ICR is the net claims paid by an health insurance company against the net premiums earned. The Bajaj Allianz Health Insurance Claim Settlement Ratio for the financial year 2018-19 is 85%. 

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FAQs

  • In how many days you need to file a claim with Bajaj Allianz Health Insurance?

    The policyholders need to submit the claim form along with the documents for the reimbursement of the claim within 15 days from the discharge date of discharge from the hospital.

  • Is there any limit for the number of claims that can be made in a year?

    The policyholders can make as many claims as possible in a year, but the total amount of claim can’t exceed the sum insured under the plan.

  • Where can I submit the documents of my claim?

    The policyholders need to submit the documents of the claim at the nearest branch of Bajaj Allianz Health Insurance.

  • In how much time Bajaj Allianz Health Insurance settles the claim?

    Bajaj Allianz Health Insurance generally settles the claim, if not rejected, within 7 working days of the receipt of the last necessary document, but will not take more than 30 days.

  • What is the claim settlement ratio of Bajaj Allianz Health Insurance for the financial year 2018-19?

    The claim settlement ratio of Bajaj Allianz Health Insurance for the FY 2018-19 is 93.68%.

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    By Narin Patel
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  • Generous Hospital Cash Benefit...

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