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.
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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.
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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.
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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.
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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
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What are the different claim settlement options offered by Care Health Insurance?
Care Health Insurance offers cashless and reimbursement claims to its customers. Cashless claims are settled within 6 hours of filing for it and reimbursement claims however take at least 7 days to get settled under Care Health Insurance plans.
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How long does it take for Care Health Insurance to settle a claim?
If the policyholder applies for a cashless claim then Care Health settles claims at the time of discharge. However, if the policyholder applies for a reimbursement claim then it will take 15 days after the discharge for the insurer to settle the claim.
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Can the policyholder track the status of the claim settlement?
Yes, Care Health Insurance provides easy online access to track the status of the claim made by the policyholder. This helps the customer to be stress-free and helps them avoid unnecessary anxiety. Additionally, InsuranceDekho also offers complete tracking support for checking your policy status or downloading your policy document.
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What documents are required while filing for a claim?
The documents required while filing for a claim under a Health Insurance policy are the claim form, medical certificate, diagnosis report, ID proof, discharge card, prescriptions, bills, and FIR (in case of an accident).
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What can be done if the claim is delayed or denied by Care Health Insurance?
Contact an InsuranceDekho advisor for any problem during claim filing or settlement. The advisor will help you with your concerns at +91-7551196989 or support@insurancedekho.com.