Max Bupa Health Insurance Claim Settlement

Max Bupa Health Insurance

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Claim Settlement Ratio92%
COVID-19 CoverYes
In-House Claim Settlement100%
Incurred Claim Ratio54%
Lifelong RenewabilityLifelong
Network Hospitals4,500+
Policies Sold 6,96,107

Claim Settlement of Max Bupa Health Insurance

Max Bupa Health Insurance is a renowned health insurance company, committed to providing smooth health claim processes. With a large number of network hospitals across the country, the insurer settles the claim as per the policy terms and conditions. As one of the most trustworthy health insurers in India, Max Bupa is recognised for its cashless claim pre-authorisation in 30 minutes and settling claims directly without the need of a third party. You can get all your health insurance claims settled by either opting for the cashless facility or the reimbursement option.

  • Claim Process for Cashless Treatment

    Cashless claims can be filed only at network hospitals of Max Bupa. Generally, Max Bupa covers 4,000+ network hospitals in the country. Here are step-by-step guides to filing a cashless claim:

    • First of all, find a Max Bupa network hospital in a city where you want to get cashless treatment
    • Intimate Max Bupa within 24 hours in emergency hospitalisation and 48 hours before admission in case of planned hospitalisation.
    • While visiting the hospital, carry your Max Bupa Health Card/Policy number and one photo ID proof.
    • Fill the pre-authorisation request form available at the hospital and submit it to the hospital.
    • After your identity is checked, the hospital submits the pre-authorisation request form to Max Bupa.
    • Once Max Bupa reviews the documents, it confirms with the hospital and policyholder about the claim status within 30 minutes.
    • Max Bupa settles the claim (as per the terms & conditions of the policy) with the hospital once all the formalities are complete.
  • Reimbursement Treatment

    Reimbursement claims can be filed in case you have got treatment at a network or non-network hospital. The step-by-step guides of reimbursement claim process are as follow:

    • Whether you choose a network hospital or a non-network hospital, notify Max Bupa within 24 hours (emergency hospitalisation) and 48 hours (planned hospitalisation).
    • Send discharge documents, invoices, medical reports along with the completely filled and signed claim form
    • Also provide Max Bupa with valid photo ID proof, and age proof 
    • After reviewing the claim request, Max Bupa will either approve, query, or reject your claim on the basis of policy terms and conditions.
    • Max Bupa settles the claim (as per policy terms and conditions) and reimburses the amount approved.
  • Documents Needed

    Here is a list of documents required for filing a reimbursement claim.

    • 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

    In case of a claim for accidental death, claim form other than the original death certificate, FIR copy, proposer’s income proof, copy of Medico-Legal Certificate, employer’s certificate, last 3 month’s salary slip, and audited accounts should be submitted.

    Have a doubt in mind? In case of any query, you can initiate contact with InsuranceDekho at 1800-1205-698.

  • Incurred Claim Ratio (ICR) of Max Bupa Health Insurance

    The Incurred Claim Ratio (ICR) is a reliable way to make sure how dependable an insurance company is. ICR reveals the pace of claim procedure and the productivity of the insurance firm in terms of revenue. The ICR of Max Bupa is 54%.

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