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Acko Health Insurance Claim Settlement

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Highlights
Claim Settlement Ratio74.09%
COVID-19 CoverAvailable
Free Health CheckupAvailable
Inception2016
Network Hospitals5,300+
RenewabilityLifetime

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Disclaimer : Actual Premium might vary basis your location, age and number of members

Claim Settlement of Acko Health Insurance

Acko General Insurance offers a quick and hassle-free claim settlement process to its policyholders. Even after being new to the insurance sector, the company has impressively settled claims thereby proving its potential in the last financial year. The general insurance company lets you make claims in two ways, namely cashless claims and reimbursement claims under its health insurance plans. Note that all claims settled by Acko General Insurance shall be payable in Indian currency only. Also, note that the company can accept or reject a health insurance claim, as the case may be, within 30 days from the date of receipt of the last document.

  • Claim Process for Cashless Treatment

    It is no rocket science to make a cashless claim under the health insurance policy offered by Acko General Insurance. All you need to do is follow the simple steps given below:

    • Find a network hospital of Acko general Insurance in a city where you want to avail cashless treatment.
    • Intimate Acko General Insurance within 24 hours in emergency hospitalisation and within 48 hours before admission in case of planned hospitalisation. Also, do not forget to carry your Acko Health ID card and a photo ID proof to the hospital.  
    • Duly fill the pre-authorization form at the network hospital and submit it to the hospital.
    • After checking your identity, the network hospital will send the pre-authorization request form to Acko General Insurance.
    • After reviewing your documents, Acko General Insurance will send an approval letter to the hospital. You can then proceed with the cashless treatment.
    • In case your request for a cashless claim gets rejected, then you can request a reimbursement claim after discharge. 
  • Reimbursement Treatment

    Although cashless treatment is a preferred choice for most when it comes to filing a health insurance claim, but you can also make a reimbursement claim under your Acko health insurance policy by following the steps given below:

    • Visit a non-network hospital of your choice.
    • Intimate Acko General Insurance within 24 hours in case of hospitalisation.
    • Avail the required treatment at the hospital.
    • Collect the relevant documents at the hospital to submit them to the insurance company. These include original documents like discharge report, prescriptions, etc.  
    • Settle the medical bill related to your treatment at the hospital at the time of discharge.  
    • Submit the documents to the insurance company after discharge.
    • After verifying your documents, the insurance company will pay you for the treatment availed, provided your health insurance policy covers you for the same.  
  • Documents Needed

    You will be required to submit the following documents at the time of claim settlement under your Acko health insurance policy: 

    • Duly filled claim form
    • Photo identity proof of the patient
    • Medical practitioner's prescription advising hospitalisation
    • Original bills with the break-up
    • Payment receipts
    • Discharge summary that includes a complete medical history of the patient along with other details
    • Investigation/diagnostic test reports etc. along with the prescription from the attending medical practitioner
    • OT notes or the Surgeon's certificate that includes the details of the operation performed (in case of surgeries)
    • Sticker or invoice of the implants, wherever applicable.
    • MLR (Medico-Legal Report copy if carried out and FIR if registered, where ever applicable
    • NEFT Details are required to enable direct credit of claim amount in a bank account) and canceled cheque
    • KYC (identity proof with address) of the proposer, where claim liability is more than Rs. 1 lakh as per AML guidelines
    • Legal heir/succession certificate, wherever applicable
    • Any other relevant document required by the company or the TPA for assessment of the claim

     

  • Incurred Claim Ratio (ICR) of Acko Health Insurance

    Incurred Claim Ratio (ICR) in health insurance is the proportion of claims paid out against the total amount of claims received in a financial year. For instance, if the company has paid out claims of Rs. 80 crore out of total premium received of Rs. 10 crore, then it indicates that the ICR of the insurance company is 80%. The Incurred Claim Ratio of Acko General Insurance for the financial year 2018-19 is 24%. Note that ICR is subject to change.  

     

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Acko Health Insurance User Reviews

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Acko Health Insurance Contact Details

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Claim Process at Acko Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

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