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
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 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
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 1800-1205-698.
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 is 62%.
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