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ManipalCigna Health Insurance Claim Settlement

The claim process at ManipalCigna Health Insurance Company 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 claims settled either through a cashless procedure or through a 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 out 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 the offline method.

    Online Process

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

    • Go to the 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 Process

    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

    Claim settlements 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 it 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 doubts 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 claim settlement ratio for FY 2018-19 is 54%.

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ManipalCigna Health Insurance Claim Settlement FAQs

  • 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. 

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