Banner

SBI Health Insurance Claim Settlement

53 reviews Rate This
Highlights
Claim SettlementDedicated Team
Claim Settlement Ratio66.08%
COVID-19 CoverYes
Network Hospitals6,000+
Policies Sold7,56,443
RenewabilityLifelong

Claim Settlement of SBI Health Insurance

The claim settlement procedure for SBI General health insurance plans is free from hassles. The overall process is extremely easy to understand and prevents a policyholder from facing inconvenience of any kind. With multiple healthcare facilities, the insurer is well-known to have settled claims of countless policyholders through its quick and simple claim procedure. Talking about the claim settlement scenarios in SBI General Health Insurance, a policyholder can either opt for cashless or reimbursement settlement of claims.

  • Claim Process for Cashless Treatment

    SBI General Health Insurance has more than 6,000 network hospitals across the country for cashless settlement of claims. Policyholders have the freedom to choose cashless settlement of claims at their nearest network hospital. The steps of the claim settlement process include- 

    • Find an SBI General Insurance network hospital in the city where you wish to undergo cashless treatment
    • Intimate SBI General immediately, both in case of emergency hospitalisation and planned hospitalisation
    • When visiting the selected network hospital, carry the cashless treatment card/policy number and member ID
    • Show the card/policy number and member ID at the insurance desk of SBI General network hospital 
    • Fill the pre-authorization form available at the network hospital
    • Once the insurer has been informed and you have filled the form, the pre-authorization form will be sent to SBI General Health Insurance
    • After the claim details are examined and reviewed, SBI General Health Insurance team will inform the policyholder and hospital with regards to approval or rejection of the claim
    • If the claim is approved, the medical expenses will be borne by SBI General Health Insurance directly. However, if the claim is rejected, the policyholder will be required to pay the bills
  • Reimbursement Treatment

    A policyholder can file a reimbursement claim at both, network and non-network hospitals. The steps in the reimbursement claim procedure include- 

    • In case of planned hospitalisation, immediate intimation to SBI General
    • In case of an emergency hospitalisation, the intimation should be given as soon as hospitalisation occurs 
    • The policyholder is required to submit a claim form with the relevant documents within 30 days of discharge from the hospital 
    • Once the investigation of the documents and claim form details is conducted, the letter of approval is sent to the policyholder by the claim management team of SBI General Health Insurance for confirmation of the approval. After verification, the claim is settled within 15 days
    • If the claim is rejected, the insured is required to respond to the query raised by the insurer or insured to uncover the reason for rejection
  • Documents Needed

    The list of documents required for claim settlement at SBI General Health Insurance include- 

    • Original investigation reports
    • Pharmacy bills with prescription
    • Final hospital discharge summary
    • FIR or post-mortem report, if happened
    • Original bills, receipts & discharge report
    • Indoor case papers with duly-filled claim form
    • Original hospital bills along with a valid photo ID proof
    • Treating doctor's report and original consultation notes
    • Nature of operation performed and surgeon's bill & receipt
    • Test reports along with attending doctor’s or surgeon’s report

     

  • Incurred Claim Ratio (ICR) of SBI Health Insurance

    The Incurred Claims Ratio or ICR indicates the net claims paid by a health insurer as against the net premiums earned. ICR is a successful approach to find how suitable and reliable a health insurer is. ICR showcases the pace of claim procedure along with the productivity of the insurance firm, in terms of revenue. The incurred claim ratio of SBI General Health Insurance for FY 2018-19 is 52%, which showcases that SBI General Health Insurance has an ample amount of assets in hand and executing the claim process in a smooth manner.

Banner

Health Insurance Calculator

Whom do you want the insurance for ?

You
Couple
Family
Father
Mother

    Select the age of all members

  • You

Where do you live ?

Choose required Coverage for yourself?

Disclaimer : Actual Premium might vary basis your location, age and number of members
Must BuyMust Buy

Why to Buy Health Insurance Policy Online from InsuranceDekho

  • Tax benefit upto 75,000*
  • Claim support everyday 10AM-7PM
  • 14 Lakh+ happy customers

Health Insurance News

  • Latest
  • Popular

SBI Health Insurance Contact Details

Reach us for help anytime

Claim Process at SBI Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

918 SBI Cashless Network Hospitals in India

Insurance Products by SBI General Insurance

SBI Health Insurance Claim Settlement FAQs

  • Can I get a refund of my money if I don’t claim in a policy period?

    No. You will not get any refund if you don’t claim in a policy period. However, you will be eligible for a ‘Cumulative Bonus’ of 5%, which can be accumulated up to 25% at the maximum. 

     

  • When should I inform the company in case of reimbursement or cashless planned period?

    You must inform the company as soon as possible in case of reimbursement or cashless planned period. 

  • What are the documents required for the reimbursement process in SBI General Insurance?

    Following are the documents required for reimbursement process in SBI General Insurance- 

    • Pharmacy bills 
    • Investigation reports  
    • FIR or post-mortem report 
    • Receipts and discharge report from the hospital 
    • Indoor case papers with duly-filled claim form  
    • Original hospital bills 
    • A valid photo ID proof
    • Treating doctor's report 
    • Nature of operation performed 
    • Surgeon's bill and receipt 
  • Whom can I contact for claim intimation and settlement purposes at SBI General Insurance?

    For claim intimation and settlement, you can get in touch with either InsuranceDekho at 7551 196 989 or can initiate contact with SBI General Insurance directly.

  • What is the Claim Settlement Ratio of SBI General Insurance?

    The Claim Settlement Ratio of SBI General Insurance for the Financial Year 2019-20 is 66.08%. 

Health Insurance Articles

  • Latest Articles
  • Popular Articles

Network Hospital in Popular Cities

CityNo of Hospital
Jaipur80
Cochin3
Ahmedabad83
Patna29
Ghaziabad32
Lucknow36
Pune131
View All

*Standard T&C Apply. All savings/offers are provided by the Insurers, which are subject to modification .For more details on risk factors, terms and conditions, please read the sales brochure of respective insurers carefully before concluding a sale. Tax benefits are subject to changes in applicable tax laws. Girnar Insurance Brokers Private Limited, (CIN: U66010RJ2016PTC054811, Regd .Off: Girnar 21, Govind Marg, Moti Doongari Road, Dharam Singh Circle, Jaipur, Rajasthan- 302004; Corp. Off: 11th Floor, Tower B, Emaar Digital Greens, Golf Course Extension Road, Sector-61, Gurugram-122102, Haryana. IRDAI License no 588. Direct Broker (Life & General) valid till 19th March 2023. Email - support@insurancedekho.com ; Helpline number: 7551196989.
You authorise Girnar Insurance Brokers Pvt Ltd (insurancedekho) to contact you through call, SMS, email, WhatsApp or any other mode in future. You hereby override your NDNC registration.