Cholamandalam MS Health Insurance Claim Settlement

Cholamandalam MS Health Insurance

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8,000+ Network Hospitals

1,03,232 Policies Issued

35% Incurred Claim Ratio

Lifelong Renewability

50.01% Claim Settlement Ratio

Dedicated Claim Settlement

Coronavirus (COVID-19) Cover

Claim Settlement of Cholamandalam MS Health Insurance

Cholamandalam MS General Insurance Company Limited is a reliable name in the general insurance sector. It is widely appreciated for providing easy and smooth claim settlement procedure to its customers. Under Chola MS plans, the policyholders can get their expenses back with two types of claim procedures such as Cashless and Reimbursement. The cashless treatment option can only be availed at the network hospitals, empanelled with the insurer. Here, Chola MS attains 7,000+ network hospitals across the country, where claims are directly settled as per the policy terms and conditions. Whereas, as per the reimbursement option, the policyholders are required to submit the bills of the expenses covered under their health insurance plan. Then after the analysis, the claim is approved and policyholders are provided with their money.

  • Claim Process for Cashless Treatment

    To settle a cashless claim with Cholamandalam MS General Insurance Company, one needs to visit its network hospital and get treated only there. If the insured individual is required to seek a claim under the policy, he/she will have to follow the following steps: 

    • Look for a network hospital equipped with the best possible facilities nearest to your place
    • Visit the hospital with the health card and show it to the concerned official present there 
    • With the help of your card, the hospital will verify your identity
    • The hospital will send a claim request to Chola MS or the TPA
    • After this, your application will be thoroughly processed, and then the decision for approval or denial is made accordingly
    • If the claim request gets approved, then insurance providing company, Chola MS, in this case, will settle the bills directly with the network hospital 
    • If rejection comes for a claim request, then the insured individual can get treated at the network hospital by making a payment on his/her own and request for reimbursement claim later 
  • Reimbursement Treatment

    If the insured is treated in a non-network hospital, he or she can file a reimbursement claim.  Also, the policyholder can request for a reimbursement claim on getting his or her cashless claim request rejected. Here are the steps to request the claim successfully:

    • Inform the insurer about the hospitalisation immediately with policy certificate number
    • Choose the medical procedure, avail it and pay the bill for the same
    • Collect all the original bills and documents at the time of discharge from the hospital
    • Duly fill the claim form and get it signed from the authority. After that, submit it with all the original documents to the insurer
    • Approval or denial will come as per the terms and conditions of the health insurance plan
  • Documents Needed

    Here are some essential documents which are needed to be submitted to successfully make a reimbursement claim:

    • Bill, certificate of discharge, receipts, card of the insurance policy
    • Cash memos from the hospital, chemist, and labs along with proper prescriptions
    • Lab test reports and any essential receipt received from pathologist
    • Detailed certificate from doctor or surgeon, where nature of the operation is elaborated 
    • Bills and receipts of attending physician, medical specialist, etc. and certificate of diagnosis

    Some other documents could also be submitted, if asked by the claim settlement team. You can also call InsuranceDekho at toll-free number 1800-120-5698 for hassle-free claim settlement.

  • Incurred Claim Ratio (ICR) of Cholamandalam MS Health Insurance

    The Incurred Claim Ratio (ICR) is a perfect measure to understand the potential of an insurance firm. It is a ratio of claim settled by the insurer to the actual premium collected by the insurance company during that period. It unveils the productivity of a health insurance firm in terms of revenue. The Incurred Claim Ratio (ICR) of Cholamandalam MS General Insurance Company Limited is 35%. 

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