Star Health Insurance Claim Settlement
Founded in 2006, Star Health Insurance is one of the leading health insurance providers with over 14000+ network hospitals facilitating cashless claims. Since its inception, the insurance company has settled 1+ Crore Claims and boasts an impressive 89.9% claim settlement ratio in the Fiscal Year 2024.
In this document, we will cover the claim settlement ratio for the past five years, necessary documents that one must file, and the steps to file a claim and check the claim status. Further, we have penned down a few tips that can help settle your claim faster.
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Claim Settlement Ratio of Star Health Insurance
Star Health Insurance Claim Settlement Ratio is calculated in percentage by dividing the total claims paid during the year by the total number of claims in a year. Let us have a look at the past five years' claim settlement ratio for Star Health Insurance:
Fiscal Year |
Claim Settlement Ratio |
2024 |
89.9% |
2023 |
99.06% |
2022 |
89.90% |
2021 |
81.7% |
2020 |
80.14% |
Why is Claim Settlement Ratio Important?
The claim settlement ratio (CSR) of a health insurance company is a crucial factor to consider when choosing a health insurance provider. CSR assists you in evaluating the company's claim-settling capacity, which is vital for you and your loved ones. The importance of CSR can be attributed to two key factors:
1. Assists in Evaluating Insurance Companies: You must take the insurer's Claim Settlement Ratio (CSR) into account when purchasing an insurance policy. CSR is statistical data that can assist you in deciding if insurance is right for you or not. You should evaluate the CSR of several businesses to determine which has the highest ratio before making a purchase. Should the need arise, you are more likely to get a claim from an insurer with a higher claim settlement ratio.
2. Displays the Percentage of Claims that the Insurer has Paid Out: An insurer's level of dedication can be determined in part by looking at their high claim settlement ratio. When an insurer has a high settlement ratio, it means that policyholders can expect to get payments when they need them. Nevertheless, the claim can be denied if the insured doesn't submit the required paperwork, which would lower the insurer's claim settlement ratio.
Star Health Insurance Claim Initiation
If you need to file a claim with Star Health Insurance, kindly follow the below-mentioned steps:
How To File a Claim
Step 1: Initiation
Immediately contact Star Health Insurance customer service or make a visit to InsuranceDekho's support center in case of an emergency or when scheduling a medical consultation:
- Dial Star Health Insurance toll-free number 18004252255 or contact the support representatives via mail at support@starhealth.in
- In order to reach an InsuranceDekho representative, make a call at 7551196989 or send an email to support@insurancedekho.com
Step 2: Document Verification
Submit and attach below-mentioned list of documents to the insurer for the claim procedure. The claim executives will go through each document and verify the details. If everything is in order, the team will proceed with claim processing.
Step 3: Tracking
Follow up regularly or enquire about Star Health Insurance's customer service to track your claim status. You can even reach out to InsuranceDekho's support team to get regular updates related to claim status
Details to be Filled in the Star Health Insurance Claim Form
A list of Documents that a policyholder must submit for the Star Health Insurance claim procedure includes:
- Fill and submit claim form with contact details, including number, email, and address
- Attach original bills and discharge certificate released by the hospital
- Original pharmacy invoices along with valid original prescriptions.
- Payment receipts and Implant invoice
- Investigation test report
- Consultation Documents
- Age-proof documents need to be attached
- Submit self-declaration/MLC/FIR (if accidental case)
- Copy of cancelled cheque
- Submit your NEFT and KYC detail
Claim Process Of Star Health Insurance
Star Health Insurance policyholders can opt for reimbursement and cashless claims based on their requirements. Here is the effective claim procedure provided by Star Health & Allied Insurance Co. Ltd:
Steps to Make a Cashless Claim:
Step 1: Get Yourself Admitted to a Network Hospital
Star Health Insurance has 14000+ Network Hospitals across India. Make a visit to any of these nearest hospitals for cashless treatment. But inform your insurance company about getting admitted to the hospital before via support@starhealth.in (email) or call 044 6900 6900 (helpline number).
Step 2: Verify and Speak with TPA
Reach out to the TPA and get yourself verified at the hospital via valid ID proof.
Step 3: Submit Pre-Authorization Form
TPA will fill out the application and submit your request to the insurer on your behalf.
Step 4: Review Documentation
The claim executive will go through the submitted documents and match your requirements with policy documents. If everything sounds good, the executive proceeds with the claim processing.
Step 5: Claim Settlement
After verification, the claim executive gives permission and pays the hospital for the treatment cost following your visit.
Steps to Make Reimbursement Claim:
Step 1: Get Yourself Admitted to a Non-Network Hospital
If you have pre-planned to be hospitalised in a non-network hospital, it is important to keep the insurer informed 24 hours beforehand. However, if there is an emergency case, the patient can contact the insurance team within the next 24 hours via email (support@starhealth.in) or call (044 6900 6900).
Step 2: Clear all Hospital Bills
From getting admitted to the treatment and discharge, the policyholder must pay the entire cost from their own pocket. Remember to collect your medical bills, discharge summary documents, and other necessary documentation for claim submission.
Step 3: Submit your Document
Fill out the claim form and attach all the documents for further verification.
Step 4: Claim Settlement
After verification and approval, the insurance company will make the payment to your account soon.
Things to Keep in Mind:
- All the documents and claim forms must be submitted to the insurer within 15 days of your release from the hospital.
- At the time of document submission, recheck all documents are properly signed and attached for a seamless claim procedure.
How to Check the Star Health Insurance Claim Status?
The policyholder can track the claim status using online channels or offline methods. Here are the steps that one must follow in order to check their claim status request.
Online Procedure
Policyholders can check their claim status directly from the insurer's online portal or via the InsuranceDekho website:
Online Procedure of Checking Star Health Policy Claim Status with InsuranceDekho
Step 1: Browse InsuranceDekho and visit the official page. In the top menu section, go to the "Support" tab and click.
Step 2: From the list of options under the support tab, click on "Track Policy".
Step 3: For OTP verification, a pop-up will appear on the screen requesting your mobile number.
Step 4: Fill in the requested details to access your account and track the claim status of your Star Health Insurance plan.
Step 5: Provide your "Policy number" in the field provided and click on the "Submit" button.
Step 6: It will display the status of your claim settlement request on your screen.
Online Procedure of Checking Star Health Policy Claim Status via the Official Site
Step 1: Browse Star Health Insurance and go to the official page. From various options available on the top menu bar, go to the "Claims" tab.
Step 2: Select "Claim Status" from the list of options available under the Claims tab.
Step 3: You will be redirected to a new page, requesting Policy Number, Intimation Number, or Health ID Card details.
Step 4: Before clicking on the "Get Claim Status" button provide the above-listed details.
Step 5: You will be redirected to a page highlighting all details related to your insurance claim.
Offline Procedure
Apart from the online portals, customers can even check the status of their claim submission using the offline method:
- Dial Star Health’s toll-free number 18004252255. The executive will in return request for a claim reference number. Provide the details to get a quick update on the claim status.
- Choose the nearest Star Health Insurance branch office, make a visit, and provide an insurance documentation copy for a quick status update.
- Contact directly to InsuranceDekho's support team via mail and request the status of your claim and coverage.
Star Health Insurance Claim Settlement Time
As per (IRDAI), the insurance company takes around 30 days to settle a claim where no investigation is involved. In case investigation is involved, the Star Health Insurance claim settlement time is 45 days from the date of payment or submission of the claim documentation.
Tips to Get Your Claim Settlement Faster
Claim procedures can be a confusing or challenging process for some customers but with the right guidance you can settle your claim quickly and efficiently, here's how:
- Understand Your Insurance Policy: Learn more about your selected policy, including coverage details, inclusions, exclusions, terms and conditions. By having a good understanding of your policy document, you will have more clarity and prevent delays.
- Maintain Proper Records: Any discussion or communication records with the insurer must be properly maintained for future reference.Email, phone calls, or any other correspondence will act as proof and help avoid misunderstanding.
- Read and Review your Policy Documents Carefully: Double-check your documents before submitting your documents for the claim procedure. Ensure nothing is missing and the claim is valid based on the available coverage.
- Regular Follow Up: Do not think your job is over after submitting your claim. It is essential to stay proactive and regularly follow up with the insurer as it helps move the process faster.
- Provide Accurate and Full Documentation: Re-check that all documents are properly attached to the claim forms before final submission. Make sure to check the details are complete and accurate. Incorrect documentation can slow or delay your claim process.
- Seek Professional Guidance (If required): In case of a claim dispute, getting legal expert guidance can be beneficial. Consulting a lawyer can help you understand your rights and resolve disputes.
Star Health Insurance Claim Assistance and Support
Using the above-listed methods, a policyholder can easily submit a claim and track status. However, if case there is any query or the policyholder requires support for the claim settlement process, use any of the following channels to connect and communicate:
Contact Star Health Insurance
Choose from the following channels to get support from Star Health Insurance for the claim process:
- Call 044 6900 6900 (Helpline number) for assistance related to claims.
- Call 044 4002 0888 (Helpline number) for senior citizen claims.
- Send detailed mail highlighting your concern to support@starhealth.in
- Whatsapp Star Health's support team at 95976 52225 for faster assistance
- If you want to accelerate the claim process related to floods, contact one of our Officers.
Contact InsuranceDekho
Customers can even reach out to InsuranceDekho's support and assistance team for concerns related to the claim process. Use any of the following sources to connect with the support team:
- Send mail to support@insurancedekho.com to highlight your claim issue
- Contact support representative via InsuranceDekho's helpline number 755 1196 989
FAQs
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How long does it take for Star Health Insurance to settle a claim?
Star Health settles the cashless claims within 24 hours of the insured filing for it and 15 days for a reimbursement claim.
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Can the status of my claim be tracked online?
Yes, you can track the status of your claim on the official website of Star Health Insurance. A few steps have to be taken to check the status of the claim made.
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What documents are required while filing for a claim?
The documents required for cashless and reimbursement claims can vary. However, the documents required for both reimbursement and cashless claims are a health card, discharge summary, pharmacy invoice with prescription, doctor’s consultation sheets, investigation reports, KYC documents, medico-legal certificate, and FIR copy in the case of an accident case, etc.
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What to do if Star Health Insurance denies or delays my claim?
The InsuranceDekho advisor helps the customer sort out any problems faced during the rejection or denial of a claim made.