ManipalCigna Health Insurance Claim Settlement

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

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.

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. 

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

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. 

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.  

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. 

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. 

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).

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. 

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

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. 

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%.