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Care Health Insurance Claim Settlement

The claim settlement process of Care Health Insurance is as great as its offerings. It has an easy process that can be processed online and is hassle-free. With a huge number of network hospitals in the list of healthcare facilities, the insurer boasts of its record claim settlement numbers through fast-paced and simple claim procedures. There are two scenarios when it comes to Care Health Insurance Claim Settlement: Cashless and Reimbursement.

  • Claim Process for Cashless Treatment

    You can avail of a cashless claim settlement of care health insurance at more than 6,000 network hospitals across the nation. The steps for the cashless claim process of Religare are the following:

    • First of all, find a Care Health network hospital in a city where you want to get cashless treatment
    • Intimate Care health within 24 hours in emergency hospitalisation and 48 hours before admission in case of planned hospitalisation.
    • While visiting a network hospital, carry the cashless treatment card or the policy number and member ID.
    • Show the card/policy number of the member ID to the insurance desk of the hospital. 
    • Fill up the pre-authorisation form correctly available at the hospital.
    • Post informing the insurer and filling out the form, the pre-authorisation form is sent to Religare health insurance company.
    • After examining and reviewing the claim details received, the Religare team conveys the policyholder and hospital about the approval or rejection.
    • In case of approval, the medical expenses will be borne by Religare directly, while in the case of rejection, the policyholder needs to pay the bills.
  • Reimbursement Treatment

    You can file a reimbursement claim in both network hospitals and non-network hospitals. The reimbursement claim process includes the following:

    • In the case of planned hospitalisation, the Care Health Insurance Company needs to be informed before 48 hours of admission.
    • In case of an emergency, the intimation should be given within 24 hours of hospitalisation. 
    • A claim form should be submitted along with the relevant documents as per the plan’s terms and conditions.
    • After an investigation of the documents and claim form details, the letter of approval is sent to the policyholder by the claim management team of Religare to confirm the approval. Post this, within 15 days the amount is reimbursed.
    • In case of rejection, the insured individual is required to respond to the query raised by the insurer, or the insured will get the reason for the rejection.
  • Documents Needed

    ​Here is a list of documents required for filing a reimbursement claim.

    • Original investigation reports                                                               
    • Final hospital discharge summary
    • FIR or post-mortem report if happened
    • Pharmacy bills along with the prescription
    • 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

    In case of any query, you can contact InsuranceDekho at 1800-1205-698. 

  • Incurred Claim Ratio (ICR) of Care Health Insurance

    The Incurred Claim Ratio (ICR) is a highly effective approach to find how viable and dependable an insurer is. ICR reveals the pace of claim procedure and the productivity of the insurance firm in terms of revenue. The incurred claim ratio of Religare is 55%. In general, an ICR value between 50% and 90% is considered good, which means Religare has ample amount of assets in hand and executing claim process smoothly as well.

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FAQs

  • What is the claim and reimbursement processing system under Care Health Insurance?

    To be able to make a claim, you have to complete the necessary form and submit the required documents as per the policy terms and conditions at the network hospital. The documents required for the same are-discharge summary, prescriptions, bills etc. Certainly, you may have to answer quite a few queries raised by the management team before the letter is issued. In case the claim is rejected, the reasons will be communicated by the team. In case of reimbursement: (i) You have to inform Care Health Insurance within 24 hours of the admission in case of emergencies. (ii) In the event of planned emergencies, the company must be notified 48 hours prior to the hospitalisation. (iii) The claim intimation can be done via Care’s toll-free number or by calling at InsuranceDekho at toll-free number 1800-120-5698. (iv) The same could also be e-mailed to customerfirst@careinsurance.com or at insurancedekho@customersupport.com.

  • How many claims have been served by Care Health Insurance Plan till today?

    More than 4.7 Lakh claims have been settled by Care Health Insurance so far.

  • Within how many days the filing of a claim is required by Care Health Insurance?

    Care Health Insurance requires the policyholder to file a claim within 15 days of discharge from the hospital for reimbursement purposes.

  • How many claims can be made by the policyholders in a year from Care Health Insurance?

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

  • In how much time Care Health Insurance settles the claim?

    Care Health Insurance settles the claim within 7 working days from the receipt of the last necessary document, but it doesn’t take more than 30 days.

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  • Got Covered For Critical Illne...

    I liked the coverage benefits available under the Care Health Insurance Plan. I bought this health insurance plan without any second thought with the help of InsuranceDekho. I must share that the care health insurance policy is affordable and I was able to buy it within a few minutes with the help of insurance experts of the InsuranceDekho team. I am satisfied!

    S
    Care
    By Sneha Mehta
    On: Apr 02, 2024
  • Helpful plan

    The Care Health Insurance Policy I recently bought at InsuranceDekho offers me multiple advantages. I bought it to get a better plan. I am happy with this Care Health insurance plan and would propose it to all. Moreover, I will revisit the website for any insurance-related requirements.

    V
    Care
    By Vinod Tanwar
    On: Mar 19, 2024
  • Professional and Efficient Ser...

    I recently got the Care Health Insurance Policy from InsuranceDekho. I must say that the Care health Insurance plan provides professional and efficient service. They have a dedicated customer team that simplifies the health insurance buying process, making it convenient and hassle-free.

    D
    Care
    By Dishu Kumar
    On: Mar 14, 2024
  • Value For Monay

    I've found that InsuranceDekho offers excellent affordable health insurance plans. The coverage I receive from the Care Health Insurance Plan for the premium paid is competitive and provides peace of mind. Thanks to the customer support team of the InsuranceDekho I found this great plan.

    S
    Care
    By Sumit Kumar
    On: Mar 13, 2024
  • Affordable Plan

    InsuranceDekho’s insurance expert executives advised me to buy the care Health Insurance Policy. I liked the Care Health policy benefits so I bought the policy instantly online by InsuranceDekho’s website via a secured payment gateway. The policy comes at an affordable premium. I am completely satisfied with the care health insurance policy.

    F
    Care
    By Falak Chopra
    On: Mar 05, 2024

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