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Cholamandalam MS Health Insurance Claim Settlement

When you are looking for a health insurance policy and cashless hospitalisation in case of a health emergency is of absolute importance to you, it is important for you to evaluate the size of the insurer’s network of empaneled hospitals. Cholamandalam MS Health Insurance has a wide network of over 8000 hospitals and as such it is a popular choice among many seekers of health insurance. Policyholders can either identify and visit an empaneled hospital in case of a health emergency (in order to get the benefit of cashless hospitalisation) or, in case there is no empaneled hospital in their vicinity, policyholders can simply use any hospital that is conveniently located and get their hospitalisation expenses reimbursed. In either situation, all expenses covered under the policy’s terms and conditions, will be appropriately covered or reimbursed by the insurer. 

The Chola MS claim settlement ratio is placed at over 50%. This is the number of claims that the insurer has settled as against the number it has received. This number gives you an idea of the profitability of the insurer. You want an insurer who is not settling each and every claim that comes their way because bogus claims are typically part of the mix. You need a company that is careful with its claim settlement process, so that they stay in business long enough to settle a genuine claim that you might make someday during your policy term. 

When you are looking for a health insurance policy, or even after obtaining it, it is sensible to research and understand the claim settlement process. In the event of a health emergency, you want to simply be able to go about the process without having to stress about doing research when you are already worried about your health or that of a loved one covered under the health insurance policy. 

In this article, you will get a clear picture of the Cholamandalam MS Health Insurance Claim Settlement process. 

Let’s take a look at the cashless claim settlement process first: 

This type of claim settlement is preferable for a lot of health insurance policyholders because it gives them a sense of certainty. They do not have to worry about their claim being rejected due to some issue later. Many policyholders might also not have funds at their disposal for procedures or hospitalisation that comes with a heavy price tag. It also saves them the trouble of having to coordinate with the Cholamandalam MS Health Insurance Customer Care, as the coordination is conducted by the hospital 

Step 1: Check for an empaneled hospital that is close enough for you to reach. Do be sure to check the updated list of hospitals, just to be sure. 

Step 2: Go ahead and visit the hospital and locate the authorities who are responsible for cashless hospitalisation.

Step 3: Display your card and undergo a verification. 

Step 4: The hospital will now forward your claim request to Cholamandalam MS Health Insurance customer care. The insurer’s dedicated claim settlement team will go over the application 

Step 5: Once approved, you can have a cashless hospitalisation and the payment will be settled directly between Cholamandalam MS Health Insurance and the hospital. 

Now let’s look at the reimbursement claim settlement process

This type of claim settlement process is preferable when there is nobody available to coordinate with the authorities at the hospital who will in turn coordinate cashless hospitalisation. For example, if you are in the thrall of a health emergency and have to be hospitalised but are unaccompanied, you might not be in a physical position to also coordinate with the hospital’s insurance claims department. The reimbursement claim process is also the popular choice in some cases where there is uncertainty about whether the claim will be settled for whatever reason. 

Step 1: As soon as you are hospitalised, call the Cholamandalam MS Health Insurance Toll free number. State the reason for your hospitalisation and your policy number. 

Step 2: Make any upfront payments required and ensure that you ask for and maintain every single bill and receipt. 

Step 3: Undergo your treatment or surgical procedure. 

Step 4: You might have to continue making payments through your hospitalisation. Do so but ensure that you ask for and maintain originals of every single bill and receipt. 

Step 5: When you are getting discharged, there is some paperwork that needs to be completed in order for you to prepare your insurance claim. Find out who the relevant authorities are and approach them to get all your paperwork in order. 

Step 6: Ensure that you have all originals of bills and the insurance paperwork from the hospital and go ahead with preparing your claim to be submitted with Cholamandalam MS Health Insurance. 

Documents that you will need to make your claim

  1. As discussed, all original copies of bills and receipts
  2. Prescriptions against bills and receipts from pharmacies 
  3. A discharge certificate from the hospital
  4. Diagnostic test copies as proof of your illness ailment 
  5. Certificates from doctors and surgeons offering diagnosis and details of treatment or surgery 

    FAQs

    What if my claim is rejected when I approach a network hospital? Do I need to go to another hospital?

    You can still undergo treatment at the network hospital and apply for reimbursement claim settlement once the hospitalisation is complete.

    The claim is taking time to come through and the hospital is requesting a payment. What should I do?

    You can go ahead and look after your health first and apply for reimbursement claim settlement once the hospitalisation is complete.

    The network hospital is out of my budget. I am afraid that my claim will be rejected and I will end up paying more than I would have at my neighbourhood hospital. What is the wisest way to proceed?

    In such a situation and especially in case you do not have the funds in hand to complete treatment at a network hospital, you could consider using a hospital within your budget and applying for reimbursement claim settlement.

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