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SBI Health Insurance Claim Settlement

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Claim Assistance
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If any policyholder searches for how to claim SBI health insurance, then the answer they always get is that it’s very easy to process. Policyholders hardly ever face any trouble while applying for SBI health insurance claims. This is one of the reasons why the SBI health insurance claim settlement ratio is very high.

The SBI General Insurance claim settlement ratio is calculated for the entire financial year. And this ratio is quite good. This is why if you are thinking of purchasing an SBI health insurance policy, then you should get it.

A policyholder can opt to get the claim settlement process started through two methods, including cashless and reimbursement settlement of claims. Today, we’ll look at the SBI health insurance claim settlement ratio and how to get the claim settlement process started.

How to Claim SBI Health Insurance?

There are over 6,000 hospitals that are part of the SBI General Insurance network. These hospitals are located all across the country. And the steps that you should follow to start off the cashless claim settlement process are:

  • Find an SBI General Insurance network hospital in your city
  • Carry your cashless treatment card with a clearly visible policy number and member ID
  • Show the card, policy number, and member ID at the insurance desk of SBI General network hospital
  • Get the pre-authorization form from the network hospital and fill it
  • After the insurer has been informed and you have filled the form, the pre-authorization form will be sent to the SBI General Health Insurance
  • SBI General Health Insurance team will inform the policyholder and the hospital regarding the approval or rejection of the claim after examining and reviewing the claim details
  • If the claim is approved, the medical expenses will be paid by SBI General Health Insurance to the hospital directly
  • If the claim is rejected, the policyholder will have to pay the bills

The cashless SBI Health Insurance claim settlement ratio is very high. Now, let’s look at the reimbursement claim settlement process.

  • SBI General Insurance should be intimated in case of a planned or emergency hospitalization as soon as possible
  • The policyholder needs to submit a claim form with all the relevant documents attached. This should be done within 30 days of discharge from the hospital
  • Investigation of the documents and claim form details will be done
  • The letter of approval is sent to the policyholder by the claim management team of the SBI General Health Insurance for confirmation of the approval
  • After verification, the claim is settled within 15 days of filing the claim
  • If the claim is rejected, the insured will be required to respond to the query raised by the insurer or insured. This is done to uncover the reason for the rejection

Documents Needed for SBI Health Insurance Claim Settlement

It is important for a policyholder to make sure that all the right documents are in place. This is why you should go through the list of all the documents which are mentioned below.

  • Original investigation reports
  • Pharmacy bills
  • Prescription bills
  • Final hospital discharge summary
  • FIR or post-mortem report, if required
  • Original bills
  • Origins receipts
  • Discharge report
  • Indoor case papers
  • Duly-filled claim forms
  • Original hospital bills
  • Valid photo ID proof
  • Treating doctor’s report
  • Original consultation notes
  • Nature of operation performed
  • Surgeon’s bill and receipt
  • Test reports
  • Attending doctor’s and surgeon’s report

SBI General Insurance Claim Settlement Ratio

Till now, we have mentioned several times that the SBI Health Insurance claim settlement ratio is quite good. We’ll look at what exactly that means in the current section. The Incurred Claims Ratio or ICR is an indicator of the net claims paid by a health insurance provider against the net premiums earned in a financial year.

The incurred claim ratio of SBI General Health Insurance for the financial year 2018 – 2019 is 52%. This showcases that the SBI General Health Insurance has an ample amount of assets in hand for executing the claim process in a smooth manner.

Reviews and Ratings

While searching for how to claim SBI health insurance, you must have come across some reviews and ratings given by policyholders. Were these reviews and ratings positive? Did you find anything negative?

If you have been thorough with your search, then you would have come across only positive reviews. If you haven’t gone through those reviews, then let’s look at some of these reviews now.

  • Amazing Critical Illness Cover by Shivika Kakkar (5 stars / 5 stars)

The last few months have been very difficult for me and my family. Thankfully, I had my SBI health insurance policy to rely back on. I cannot tell you how many times this policy has come to my aid in the last few months. I’m very thankful to SBI General Insurance for all their services and help.

  • Affordable Premium by Shalini Sachdeva (4 stars / 5 stars)

I have recently purchased my SBI General Critical Illness insurance plan. The premium rate is very affordable and the entire process was very smooth for me. The customer service department was very helpful.

FAQs

I haven’t applied for a claim in the policy period. Can I apply for a refund?

No, you will not get any refund even if you haven’t applied for a claim in a policy period. However, you will be eligible for a cumulative bonus of 5%. This bonus can be accumulated up to a maximum of 25%.

I want to apply for reimbursement or a cashless planned claim. When should I inform SBI General Insurance regarding the same?

Ideally, policyholders should inform the company as soon as possible in case of reimbursement or cashless planned period.

Please name the documents that are required for starting off the reimbursement process for my SBI General Health Insurance policy.

The documents that are required for starting off the reimbursement process for your SBI General Health Insurance policy are:
Pharmacy bills
Investigation reports
FIR or post-mortem report
Receipts from the hospital
Discharge report from the hospital
Indoor case papers
Duly-filled claim form
Original hospital bills
A valid photo ID proof
Treating doctor’s report
Nature of operation performed
Surgeon’s bill
Surgeon’s receipt

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