Magma HDI Health Insurance Claim Settlement
Magma HDI is a trusted name in the insurance industry. It is praised across the market for delivering a simple and efficient claim settlement process to its policyholders. Under the policies of Magma HDI General Insurance Company, the customers can receive their treatment expenses back through a cashless claim procedure or reimbursement claim procedure. The cashless procedure can be availed only at the hospitals present in the network of insurance-providing firms. Here, Magma HDI health insurance company possesses around 4,100+ network hospitals across the nation, where claims are provided directly according to policy terms and conditions. However, when it comes to reimbursement procedures, the customers have to submit the medical bills that have the coverage under the health insurance policy, which gets approved post-analysis.
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Claim Process for Cashless Treatment
To settle a cashless claim with Magma HDI, proposers are required to follow these steps:
- Find a hospital in the network of the insurer with proper amenities
- Reach the network hospital with a health card and show it to the officials there
- The hospital will verify your identity and send a claim request to Magma HDI
- The application will be processed to approve or deny the claim requested
- If the request for a claim gets approved, Magma HDI will adjust the bill directly with the network hospital
- In the cases of rejection, the insured individual can request for reimbursement claim after getting discharged from the hospital
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Reimbursement Treatment
If a policyholder is treated in a non-network hospital, he or she can request a reimbursement claim settlement. Besides, the policyholder can request this claim procedure on getting the rejection for a cashless claim. Here are some steps to successfully request for the reimbursement procedure:
- Immediately convey Magma HDI about the hospitalisation with policy certificate number
- Select the medical treatment, avail it, and make payment for its expense
- Seek and gather original documents and bills of all the procedures while getting discharged from the hospital
- Fill out the claim form properly and get it signed by the authority before submitting it to the insurer with all the relevant documents
- Approval or denial of the claim is decided according to the terms and conditions of a specific plan and then the amount is reimbursed
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Documents Needed
Following are the documents required to be properly filled and submitted for making a successful claim request:
- Invoices or medical bills, discharge certificates, health insurance policy card
- Cash memos, chemist bills, and lab reports and bills along with proper prescriptions
- Detailed prescription from doctor comprising the type of treatment/operation
- Doctor or physician bills with the complete certificate of diagnosis
- In addition to these, some other documents can be submitted as well, if needed by the authorized claim settlement team
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Incurred Claim Ratio (ICR) of Magma HDI Health Insurance
The Incurred Claim Ratio (ICR) is a measure to gauge the potential of an insurance firm in terms of effectiveness and liquidity. Basically, it is a ratio of the total amount of claims settled by the insurance-providing firm to the amount of premium gathered by the health insurance company during a particular period. It reveals the productivity of an insurer. The Magma HDI Health Insurance Claim Settlement Ratio is 90% for FY 2018-2019.
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FAQs
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What are the documents required for the settlement of the claim?
The documents required to be submitted for settlement of the claim are :
- Duly filled claim form
- Certificate from the physician
- Medicine prescriptions
- Medical bills
- Diagnosis reports such as x-ray scan, ECG, etc.
- Details of the discharge
- Final receipts from the hospital
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Where can I contact for claim settlement services from Magma HDI?
You can intimate your claims at toll-free number 18002663202. Also, you can e-mail the claim details at customercare@magma-hdi.co.in.
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Do I need to spend at least 24 hours in the hospital to get a claim?
Yes, every insured needs to be admitted for at least 24 hours in the hospital to get a claim. In the case of daycare procedures only, the duration can be less than 24 hours.
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What is the procedure to avail the cashless facility in Magma HDI network hospital?
The policyholders can avail the cashless facility at our network hospital or can ask for claim as reimbursement. With Magma HDI, claims are now easy to access. You just need to download "Magma HDI" mobile app or visit the website "www.magma-hdi.co.in" to avail any of the following:
- Intimate and track claims
- Avail wellness services
- Download forms
- Search hospital for cashless facility
- Access your policy features and health card and more
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What is the Claim Settlement Ratio of Magma HDI General Insurance Company?
The Claim Settlement Ratio of Magma HDI General Insurance Company for FY 2019-20 is 95.17%.