Care Health Insurance Claim Settlement

Care Health Insurance

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Highlights

Network Hospitals7,400+
Policies Sold6,91,739
Incurred Claim Ratio55%
Lifelong RenewabilityLifelong
Claim Settlement Ratio92.83%
In-House Claim Settlement100%
COVID-19 CoverYes

Claim Settlement of Care Health Insurance

The claim settlement process of Religare Health Insurance is as great as its offerings. It has an easy process that can be processed online and is absolutely hassle-free. With a huge number of network hospitals in the list of healthcare facilities, the insurer boasts of its record claim settlement numbers through fast-paced and simple claim procedure. There are two scenarios when it comes to Religare Claim Settlement: Cashless and Reimbursement.

  • Claim Process for Cashless Treatment

    You can avail a cashless claim at more than 6,000 network hospitals across the nation. The steps for cashless claim process of Religare are the following:

    • First of all, find a Religare network hospital in a city where you want to get cashless treatment
    • Intimate Religare within 24 hours in emergency hospitalisation and 48 hours before admission in case of planned hospitalisation.
    • While visiting a network hospital, carry the cashless treatment card or the policy number and member ID.
    • Show the card/policy number of the member ID to the insurance desk of the hospital. 
    • Fill up the pre-authorisation form correctly available at the hospital.
    • Post informing the insurer and filling the form, the pre-authorisation form is sent to Religare health insurance company.
    • After examining and reviewing the claim details received, Religare team conveys the policyholder and hospital pertaining to the approval or rejection.
    • In case of approval, the medical expenses will be borne by the Religare directly, while in the case of rejection the policyholder needs to pay the bills.
  • Reimbursement Treatment

    You can file a reimbursement claim in both network and non-network hospitals. The reimbursement claim process includes the following:

    • In the case of planned hospitalisation, the Religare Health Insurance Company needs to be informed before 48 hours of admission.
    • In case of an emergency, the intimation should be given within 24 hours of hospitalisation. 
    • A claim form should be submitted along with the relevant documents as per the plan’s term and conditions.
    • After investigation of the documents and claim form details, the letter of approval is sent to the policyholder by the claim management team of Religare to confirm the approval. Post this, within 15 days the amount is reimbursed.
    • In case of rejection, the insured individual is required to respond to the query raised by the insurer or insured will get the reason for the rejection.
  • 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 any query, you can contact InsuranceDekho at 1800-1205-698. 

  • Incurred Claim Ratio (ICR) of Care Health Insurance

    The Incurred Claim Ratio (ICR) is a highly effective approach to find how viable and dependable an insurer is. ICR reveals the pace of claim procedure and the productivity of the insurance firm in terms of revenue. The incurred claim ratio of Religare is 55%. In general, an ICR value between 50% and 90% is considered good, which means Religare has ample amount of assets in hand and executing claim process smoothly as well.

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