Claim Settlement of United India Health Insurance
Claim settlement procedure at United India Insurance is quite simple and fast-paced. Free from hassles of any kind, the claim settlement process is easy to understand and doesn’t put policyholders in inconvenience. Backed by a vast number of healthcare facilities, United India Insurance has settled claims of unnumbered policyholders without any delay. What’s best is that it is up to the policyholders to choose their preferred claim settlement mode, cashless and reimbursement being the two available alternatives.
Claim Process for Cashless Treatment
United India Health Insurance has more than 7000 network hospitals all over India for cashless settlement of claims. Policyholders are provided with the freedom of opting their cashless settlement of claims at their nearest network hospital. The steps policyholders need to follow for the claim settlement process include-
- Find a United India Insurance network hospital in the city where you wish to avail cashless treatment
- Intimate United India Insurance/TPA within 24 hours, in case of an emergency hospitalisation and 72 hours prior to admission in the case of a planned hospitalisation
- Carry cashless treatment card/policy number and member ID when visiting the selected network hospital
- Show the card/policy number and member ID at the insurance desk of United India Insurance network hospital
- Fill the pre-authorisation form available at the network hospital
- Once insurer/TPA has been informed and you have filled the form, the pre-authorisation form will be sent to TPA through the hospital
- After the claim details are examined and reviewed, TPA 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 insurer directly. However, if the claim is rejected, the policyholder will have to pay the bills
A policyholder can file a reimbursement claim at both, network and non-network hospitals. The steps to be followed by the policyholder in the reimbursement claim procedure include-
- In case of planned hospitalisation, United India Insurance/TPA should be informed 72 hours prior to admission in the hospital
- In case of an emergency hospitalisation, the intimation should be within 24 hours of hospitalisation
- The policyholder is required to submit a claim form with the relevant documents within 15 days of discharge from the hospital
- Once the investigation of the documents and claim form details is carried out, the letter of approval is sent to the policyholder by the claim management team of the insurer/TPA 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 TPA to uncover the reason for rejection
The list of documents needed for claim settlement procedure at United India 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 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
In case of a query related to the documents required, feel free to initiate contact at InsuranceDekho at 1800-1205-698.
Incurred Claim Ratio (ICR) of United India Health Insurance
The Incurred Claim Ratio or ICR showcases the net claims paid by a health insurer as against the net premiums earned. ICR is a successful approach that helps in finding how suitable and dependable a health insurer is. ICR indicates the pace of claim procedure along with the productivity of the insurance firm, in terms of revenue. The incurred claim ratio of United India Health Insurance is 110.95%*. *The incurred claim ratio changes from time to time.
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