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Edelweiss Health Insurance Claim Settlement

Edelweiss General Insurance is one of the top insurance providers in India. The company ensured an easy and incredible hassle-free claim settlement process. The Edelweiss health insurance claim settlement ratio is also very high which is why so many customers are attracted to Edelweiss health insurance policies.

According to official documents, currently, Edelweiss General Insurance has over 2,500 hospitals within its network. These hospitals are located all across the country and help the company to settle claims efficiently and provide great medical services.

With Edelweiss General Insurance one can always rely on claim approval irrespective of whether the case is of emergency or planned hospitalization. In case of cashless hospitalization, the bills are directly settled with the network hospital and for reimbursement claims, the amount is transferred to the account of the policyholder.

Edelweiss General Insurance Claim Process

You might find it interesting to note that even the Edelweiss car insurance claim settlement ratio is very high. This goes to show the amount of trust that individuals place in this company. This is why if you want to place a claim request, then you can do that without any worry.

However, what if you don’t know how to apply for a cashless claim. In that case, you should follow the steps given below.

  • Find an Edelweiss General Insurance network hospital that is located near you
  • In case of emergency hospitalization, make sure to inform the company within 48 hours of hospitalization
  • For planned hospitalizations, the company should be informed 72 hours in advance
  • Carry your health card issued by the insurance provider
  • Do not forget to carry a valid photo ID proof
  • Fill the pre-authorization request form that you can get directly from the network hospital
  • Submit the form at the hospital help desk
  • After verifying the identity of the patient, the form will be sent to the Edelweiss General Insurance branch office
  • If the claim request is approved, then the hospital bills will be paid by the insurance provider

The Edelweiss health insurance claim settlement ratio also includes the data of reimbursement claims. And the steps required for submitting a reimbursement claim are:

  • Reimbursement claims can be filed at both network and non-network hospitals
  • The insurance provider should be informed as soon as possible in the case of planned or emergency hospitalization. Ideally, the intimation should be done within 48 hours of emergency hospitalization and before 72 hours of planned hospitalization
  • Documents, including the discharge summary, hospital bill, invoice, and medical reports should be collected from the hospital
  • The policyholder can download the claim form from the office Edelweiss General Insurance website
  • Fill the claim form and sign it
  • Annex a valid photo ID card and the cashless card
  • Send all the documents to the address of the Edelweiss General Insurance branch office
  • The insurance provider will approve the claim request after reviewing the claim form and documents thoroughly

Documents Required for Filing Edelweiss Health Insurance Claim Request

The reason why the Edelweiss health insurance claim settlement ratio is so high is that most policyholders submit the correct documents to the company. You should do the same if you are applying for a claim. But what if you are not familiar with what these documents are? In that case, we have got you covered.

  • Original investigation reports
  • The discharge summary from the hospital
  • Pharmacy bills
  • Medical prescriptions
  • FIR, if required
  • Post-mortem report, if required
  • Original bills
  • Original receipts
  • Discharge report
  • Filled claim form
  • Indoor case papers
  • A valid photo ID
  • Doctor’s report
  • Original consultation notes
  • Surgeon’s bill
  • Nature of operation performed
  • Test reports
  • Attending doctor’s report
  • A canceled cheque with the name of the policyholder and bank account details

The Edelweiss Health Insurance Claim Settlement Ratio

For the financial year of 2018 – 2019, the Edelweiss health insurance claim settlement ratio was reported as being 115%. This data was revealed by the Insurance Regulatory and Development Authority (IRDAI) in its annual report.

How to Buy Edelweiss Health Insurance Policies?

Till now, we have talked about the Edelweiss health insurance claim settlement ratio and how one can request a claim. But what if you are not even an Edelweiss policyholder? In that case, you need to ask yourself. Would you like to be an Edelweiss policyholder?

If yes, then you can purchase an Edelweiss health insurance policy either through the online method or through the offline method. It is simpler for many customers to use the online route as the Edelweiss health insurance policy can directly be purchased from the official Edelweiss website.

However, if you would prefer the offline method, then you will have to visit the Edelweiss General Insurance branch office. Carry all the relevant documents with you and select the health insurance policy you want to buy. Submit the documents and pay the premium to finalize your policy purchase.

Reviews and Ratings

The positive reviews given by customers to Edelweiss General Insurance are given below.

  • Great Edelweiss Health Insurance Claim Settlement Ratio by Nidhi Thakur (5 stars / 5 stars)

I was attracted to Edelweiss General Insurance due to the high claim settlement ratio reported by the company. The health insurance policies were also very attractive and this is why I decided to purchase the policy. In hindsight, that was one of the best decisions I have ever made. All of my claim requests till now have been approved!

  • Need of the Hour by Abhishek Upadhyay (5 stars / 5 stars)

I have been hearing left and right about how important it is to purchase a health insurance policy. But I couldn’t find the right policy till I came across Edelweiss health insurance plans. The company provides complete medical coverage to me and my entire family. I couldn’t ask for anything more!


I have an Edelweiss health insurance policy. How many claims can I make in a year for it?

There are no limitations or set of the number of claims that one can make in a policy year. The only rule here is that the maximum amount of claims should not exceed the maximum sum insured value.

Can I place a reimbursement claim request to Edelweiss General Insurance?

Yes, Edelweiss General Insurance accepts reimbursement claim requests. In reimbursement claims, the policyholder is reimbursed the amount of money that he or she has paid from his or her pocket. In the case of cashless treatment, the payment is directly made to the network hospital.

When should I inform Edelweiss General Insurance regarding hospitalization to ensure proper claim settlement?

Policyholders must convey information related to the admission to the hospital within 48 hours of emergency hospitalization. In the case of planned hospitalization, the intimation should be done 72 hours in advance.

What is the minimum amount of time that one needs to spend at a hospital to become eligible for a claim request?

Individuals must stay for at least 24 hours in the hospital to ask for a successful claim settlement. In the case of day care procedures, the hours of hospitalization can be less than 24 hours.

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