Kotak Mahindra Health Insurance Claim Settlement

A policyholder can file a reimbursement claim at both, network and non-network hospitals. The steps in the reimbursement claim process include- 

• In the case of planned hospitalisation, the Kotak General should be informed before 48 hours of admission
• In case of an emergency hospitalisation, the intimation should be given within 24 hours of hospitalisation 
• The policyholder is required to submit a claim form with the relevant documents within 30 days of discharge from the hospital 
• After the investigation of the documents and claim form details is conducted, the letter of approval will be sent to the policyholder by the claim management team of Kotak General Health Insurance to confirm the approval. After verification, the claim will be settled within 15 days
• In case of rejection, the insured individual is required to respond to the query raised by the insurer or insured to uncover the reason for rejection

The list of documents required for claim settlement at Kotak General Health Insurance include- 

• Valid photo ID proof
• Original investigation reports
• Post-mortem report (if applicable)
• Original hospital bills and receipts
• Pharmacy bills along with the prescription
• Indoor case papers and duly-filled claim form
• Treating doctor's report and original consultation notes
• Nature of operation performed and surgeon's bill and receipt
• Discharge report

The Incurred Claim Ratio or ICR refers to the net claims paid by a health insurer as against the net premiums earned. It is a highly effective approach to find how viable and reliable a health 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 Kotak General Health Insurance for FY 2018-19 is 47%, which showcases that it has an ample amount of assets in hand and executing claim process quite smoothly.