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ManipalCigna Health Insurance Claim Settlement

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Highlights
Claim Settlement Ratio85.72%
COVID-19 CoverYes
In-House Claim SettlementAvailable
Incurred Claim Ratio54%
Network Hospitals6,500+
Policies Sold2,29,817
RenewabilityLifelong

Claim Settlement of ManipalCigna Health Insurance

The claim process at ManipalCigna is easy, fast and hassle-free. The insurer makes policyholders aware enough to go through the process quite comfortably. ManipalCigna has been widely appreciated in the health insurance industry for its services and claim settlement. Like in other health insurance companies, at ManipalCigna, policyholders can get their claim settled either through a cashless procedure or through reimbursement procedure.

  • Claim Process for Cashless Treatment

    Under this type of facility, treatment should be taken at network hospitals. ManipalCigna has 6,969+ hospitals in its network. In this process, you don't need to make any medical related payment. The health insurer is directly eligible for the payments related to the health care expenses covered in the health insurance plan. Follow the below guidelines:

    • First of all, find a ManipalCigna network hospital in a city where you want to get cashless treatment
    • Intimate ManipalCigna within 48 hours in emergency hospitalisation and 3 days before admission in case of planned hospitalisation
    • While visiting the hospital, carry the ManipalCigna cashless treatment card and one photo ID proof
    • Fill the pre-authorization request form available at the hospital and submit it to the hospital
    • After your identity is checked, the network hospital sends the pre-authorization request form to ManipalCigna
    • The claim details and documents will be reviewed by ManipalCigna​ as per the policy terms and conditions
    • If the insurer approves the same, the medical bills will be borne by them
    • ManipalCigna may request certain additional documents if required
    • On the denial of the claim, the amount of the denied treatment or procedures will need to be paid by the policyholder.

    How to Check Manipal Cigna Health Insurance Plan Claim Status

    To track the status of your claim, you can either follow the online method or offline method.

    Online Process

    To track your claim status, you can simply follow the steps given below:

    • Go to Manipal Cigna Health Insurance website and select the claim section.
    • Then, in order to track the status of your claim, simply enter details such as Your policy number and date of birth.
    • Afterward, click on ‘Submit’. You can check your claim status.

    Offline

    If you are not able to check the status of your claim online, you can directly contact Manipal Cigna Health Insurance at 1800-102-4462(Toll Free number) or email them at customercare@manipalcigna.com. Also, you can visit Manipal Cigna Health Insurance’s nearest branch and ask customer care representatives for help. They will ask you regarding details like your policy intimation number, policy ID card number to give you updates regarding your claim status.

  • Reimbursement Treatment

    Claims for reimbursement are made when policyholders avail treatment at a network or non-network hospital.

    • Before you look for medicinal treatment, inform about your hospitalisation at toll-free helpline 3 days in advance for a planned admission, while for emergency case call within 48 hours of hospitalisation 
    • Avail treatment and settle all hospitalisation costs
    • Collect original medical bills, receipts, examination reports, pharmacy store bills, etc, at the time of discharge
    • Get the reimbursement claim form and get it duly filled
    • Visit the closest ManipalCigna branch within 15 days from the discharge to submit the claim reports 
    • ManipalCigna will access the claim reports and ask for more records if required
    • After analyzing all the details, the insurer will approve or deny the claim 
    • If the insurer gives the approval, the amount of the reimbursement claim will be paid to the policyholder either through cheque/DD or net banking.
  • Documents Needed

    Here are the relevant documents, which are required to be sent to ManipalCigna for easy and hassle-free claim settlement:

    • 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.

    Have any doubt about the ManipalCigna claim settlement process, give a call to InsuranceDekho at 7551196989. 

  • Incurred Claim Ratio (ICR) of ManipalCigna Health Insurance

    A health insurance organization earns through the premiums that customers pay. And with that money, the insurers settle the claims too. So, the percentage of earning and paying in a health insurance firm is known as Incurred Claim Ratio (ICR). This denotes the financial soundness of a company too as the remaining amount after payments are made from earnings is called profit. The ICR of ManipalCigna Health Insurance for FY 2018-19 is 54%.

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ManipalCigna Health Insurance User Reviews

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    InsuranceDekho has many affordable plans for everyone. The ManipalCigna Health Insurance Plan that I choose fo...

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    On: Mar 31, 2023
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      The InsuranceDekho website has the best health insurance plan for you depending on your specific needs...

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      There is a lot of plans available on the insuranceDekho website, out of all those I chose the ManipalC...

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  • Well-managed website

      The InsuranceDekho website is very well-managed. It was way too easy for me to navigate the health ins...

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    The buying process from the InsuranceDekho website is quick and easy. I recently bought ManipalCigna’s h...

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ManipalCigna Health Insurance Contact Details

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Claim Process at ManipalCigna Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate within 3 days prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate within 3 days prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

1439 ManipalCigna Cashless Network Hospitals in India

ManipalCigna Health Insurance Claim Settlement FAQs

  • What is the time limit for claim submission in case of the cashless facility?

    You need to submit the claim within 15 days from the date of discharge from the hospital.

  • What is a reimbursement amount?

    It is the amount paid back to you by the insurance company for admissible medical expenses you have incurred.

  • What is planned hospitalisation?

    When you plan your treatment in advance, it is called planned hospitalisation. The intimation of such hospitalisation should be given a minimum of 3 days before the date of hospitalisation.

  • What is a cashless claim? Please explain.

    In a cashless claim, you need not to pay any amount to the hospital for getting admission and availing treatment. To avail cashless treatment, get medical treatment at network hospitals of ManipalCigna. 

  • Is cashless claim treatment available at ManipalCigna?

    Yes, cashless claim treatment is available at ManipalCigna. To get this benefit, you need to avail treatment at a ManipalCigna network hospital. 

  • What is the reimbursement claim?

    Reimbursement claim means ManipalCigna refunds all the amount incurred during the treatment at a non-network hospital. This is applicable when you don’t find a network hospital in your city and choose to seek treatment at a non-network hospital by paying hospital bills and other amounts from your pocket. After getting discharged, you will need to send all the documents to ManipalCigna to receive the amount. 

  • What are the documents required for reimbursement claims at ManipalCigna?

    The list of documents you need to send to ManipalCigna for a reimbursement claim is original hospital bills, original discharge summary, other reports like medicine bills along with the prescription, test reports, attending physician’s reports, surgeon’s reports, etc. and follow-up checkup reports if you have any.  

  • Whom should I contact for claim intimation and settlement?

    You can notify either InsuranceDekho or ManipalCigna directly by calling at customer care numbers for planned or emergency hospitalisation. InsuranceDekho's toll-free number is 7551196989. 

  • Is cashless facility available in all cities of India?

    To know the right answer, we advise you to visit the official website of ManipalCigna wherein you will find a list of network hospitals. Or you can contact us anytime at our toll-free number 7551-196-989. 

  • How to calculate the Claim Settlement Ratio (CSR) of ManipalCigna Health Insurance?

    To calculate the Claim Settlement ratio of ManipalCigna Health Insurance, you can use the formula given below:
    Claim Settlement Ratio=(Total claims settled or paid)/(Total claims received+Outstanding claims at the beginning of the year).

  • How to process cashless insurance claim settlement of ManipalCigna Health Insurance?

    To process cashless claim(s) under ManipalCigna Health Insurance, you are required to follow the steps given below: 

    • Intimate ManipalCigna Health Insurance 3 days prior to admission in case of planned hospitalisation and within 24 hours of hospitalisation in case of emergency hospitalisation 
    • Show your health card and a valid photo ID at the network hospital 
    • Your documents will be verified by the insurance company 
    • If the claim has been made in accordance with the terms and conditions under the policy, then the insurer will settle the bill directly at the network hospital. 
  • How to make reimbursement claims under health insurance plans offered by ManipalCigna Health Insurance?

    To make a reimbursement claim under ManipalCigna Health Insurance, you are required to follow the steps given below:

    • Intimate ManipalCigna Health Insurance about the treatment
    • Avail the required treatment at the non-network hospital of your choice and pay the bill from your own pocket
    • Submit the claim documents to the corporate office or the nearest branch of ManipalCigna Health Insurance 
    • The insurance company will verify your documents and pay for the treatment if the claim made by you is in accordance with the terms and conditions of your policy
  • What is the time frame within which the hospitalisation must be reported to ManipalCigna Health Insurance?

    In case of planned hospitalisation, you must convey ManipalCigna Health Insurance 3 days in advance by contacting them on the toll-free number 1800-419-1159. Whereas, in case of emergency hospitalisation, the insurance company should be informed on the same number within 24 hours of hospitalisation. 

  • What is the Claim Settlement Ratio of ManipalCigna Health Insurance?

    As per the IBAI’s General Insurance Claim Insights Handbook For Policyholders-5th Edition, the Claim Settlement Ratio of ManipalCigna Health Insurance for the financial year 2019-20 is 85.72%. 

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Network Hospital in Popular Cities

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Chennai292
Mumbai183
Noida24
Ahmedabad113
Pune212
Hyderabad304
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