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Care Health Insurance Claim Settlement

Care Health Insurance, previously known as Religare Health Insurance, was founded in 2012 and has since become one of the leading health insurance companies in India. With a claim settlement ratio of 95%, the company has served over 7 crore lives and settled more than 38 lakh claims, providing customers with dedicated and customer-centric service. Care Health Insurance aims to ensure that their customers' road to recovery is as stress-free as possible.
This page covers details on Care Health Insurance's claim settlement ratio, how to check claim status, details in the claim form, and claim initiation. To check the claim status, visit the website or call customer service. Fill out accurate details in the claim form to avoid delays. Contact customer service to initiate a cashless or reimbursement claim.[1]


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Claim Settlement Ratio of Care Health Insurance

The claim settlement ratio of Care Health Insurance is derived by dividing the total claims paid within 30 days by the overall claims paid. Below are the Claim Settlement Ratios for the previous five years:-

Fiscal Year

Claim Settlement Ratio

2023

95%

2022

90%

2021

87.3%

2020

95.2%

2019

95.2%

Why is Claim Settlement Ratio Important?

When selecting a health insurance company, it is essential to consider a company's claim settlement ratio (CSR) as it is a reliable insurance metric. CSR helps you determine the company's ability to settle claims, which is crucial for you and your dear ones. There are two main reasons why the CSR is important:-[2]


  1. Assists in Evaluating Insurance Companies:- When you are buying a health insurance policy, it's important to consider the Claim Settlement Ratio (CSR) of the insurer. CSR is a metric that helps you determine whether an insurer is suitable for you or not. Before making a purchase, you should compare the CSR of different companies to find the one with the highest ratio. The higher the claim settlement ratio of an insurer, the more likely you are to receive a claim in case you need to make one.


  1. Displays the Percentage of Claims that the Insurer has Paid Out:- A high claim settlement ratio is an important factor in deciding whether an insurer is dedicated. A high settlement ratio indicates the insurer is more likely to pay out claims when policyholders need them. However, if the insured fails to provide the appropriate documentation, the claim may be rejected, leading to a decrease in the insurer's claim settlement ratio.

Care Health Insurance Claim Initiation

If you need to file a claim from Care Health Insurance, please follow the process mentioned below:-

How To File a Claim

Step 1:- Initiation


When you make a medical appointment or have an emergency, contact InsuranceDekho or Care Health Insurance customer support immediately.



  • To reach an InsuranceDekho representative, please call our customer support number 7551196989 or send us an email at support@insurancedekho.com.[5]


Step 2:- Verification


The claim team at Care Health Insurance will check all of your documents when you submit them. If everything is in order, your claim will proceed with processing.


Step 3:- Tracking


You can get in touch with Care Health Insurance's customer service to follow up on your claim. To aid you in receiving frequent updates, you may also get in touch with a customer support agent at InsuranceDekho.


Tax Save
Save Tax upto ₹75000*
Under Section 80D

*Tax benefits are subject to changes in Income Tax Act.

Details to be Filled in the Care Health Insurance Claim Form

There are two sections to the information that must be completed to submit a claim for Care Health Insurance. The separated information is listed as follows:

PART A

PART B

Self Declaration

Hospital Details

Employee Details

Doctor Details

Policy Copy

Patient Details

Discharge Summary

Treatment Details

Hospital Bills

Hospital Declaration

ETF Details



Furthermore, the information listed below is also necessary:

  1. Duly filled claim form

  2. Discharge or daycare summary

  3. Final hospital bill

  4. Payment receipts

  5. Investigation report

  6. Pharmacy bills

  7. Implant invoice

  8. Doctor Prescriptions

  9. Consultation Papers

  10. Age Proof

  11. Indoor Case Paper

  12. Copy of cancelled cheque

  13. KYC Form

Claim Process Of Care Health

More than 22,900 healthcare establishments offer cashless treatments through Care Health Insurance. Notification of planned procedures at non-network hospitals must reach Care Health Insurance 48 hours in advance, or within 48 hours of the patient being admitted to the hospital in the case of an emergency. Notably, authorization for cashless care at non-network hospitals is contingent upon meeting the requirements outlined in your Care Health Insurance policy as well as the hospital's agreements.


Furthermore, the actions to take in the event of cashless and reimbursement claims are listed below:

Cashless Claims

  • Go to the closest network hospital of care health company.

  • Approach the front desk to speak with the TPA, or third-party administrator.

  • TPA will complete and submit your application to Care Health Insurance on your behalf.

  • If everything is authorized, the claim executive will examine the reports and proceed with processing the claim.

  • You can begin receiving therapy at the hospital as soon as you receive approval.

  • Your insurer and the hospital will settle the bill directly after treatment.

Reimbursement Claims

  • Notify Care Health Insurance of your hospital stay (within 48 hours in the event of an emergency, and 48 hours in advance if it is planned).

  • Pay your hospital costs in full and turn in all required paperwork.

  • Complete and send in a claim form.

  • Await the insurer's permission and status report.


Keep in mind that you must:

  • Submit all paperwork with your claim form within 15 days of discharge.

  • Save all properly signed paperwork for submission to ensure a seamless claim procedure.[3]

How to Check the Care Health Insurance Claim Status?

Use the procedures listed below to verify the status of your Care Health claim both online and offline:-

Online

  • Go to the Care Health Insurance webpage.

  • Select the "Already a Customer" option located in the upper right corner.

  • Select "Claim Genie" from the options on the tab.

  • You'll be taken to the claim page.

  • Enter your information to begin the claim procedure.

Offline

  • Submit a copy of your insurance document when you visit the Care Health Insurance branch that is closest to you.

  • Speak with a branch office executive who can help you by understanding your coverage and the status of your claim.

You can also receive the update by sharing your claim reference number with the customer care executive over the phone at 18001024499, which is a toll-free number, or by calling any number from the list provided on the Care Health Insurance website.


Care Health Insurance Claim Settlement Time

The Insurance Regulatory and Development Authority of India (IRDAI) states that it typically takes an insurer 30 days from the date of payment or the filing of claim documents to settle a claim.

Tips to Get Your Claim Settlement Faster


To expedite the settlement of your claims, bear the following in mind:

  • Gain a deeper understanding of your policy.

  • Send only completed documents.

  • Keep a record of all your correspondence with your insurance.

  • Maintain an active policy.

  • Examine each paper you have carefully.

  • Consult an attorney if necessary.

Care Health Insurance Claim Assistance and Support

To get claim assistance and support from Care Health Insurance:[4]


  • Call toll-free at 18001024499.

  • Email at customerfirst@careinsurance.com

  • Whatsapp Care Health Insurance by saying 'Hi' at 8860402452

To get claim assistance and support from InsuranceDekho you can:[5]


  • Email:- support@insurancedekho.com

  • Contact No:- +91-755 1196 989.

References

[1] https://www.careinsurance.com/

[2] https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio

[3] https://www.careinsurance.com/health-insurance-claim-forms.html

[4] https://www.careinsurance.com/contact-us.html

[5] https://www.insurancedekho.com/contact-us



Health Insurance News

FAQs

  • What are the different claim settlement options offered by Care Health Insurance?

    Care Health Insurance offers cashless and reimbursement claims to its customers. Cashless claims are settled within 6 hours of filing for it and reimbursement claims however take at least 7 days to get settled under Care Health Insurance plans.

  • How long does it take for Care Health Insurance to settle a claim?

    If the policyholder applies for a cashless claim then Care Health settles claims at the time of discharge. However, if the policyholder applies for a reimbursement claim then it will take 15 days after the discharge for the insurer to settle the claim.

  • Can the policyholder track the status of the claim settlement?

    Yes, Care Health Insurance provides easy online access to track the status of the claim made by the policyholder. This helps the customer to be stress-free and helps them avoid unnecessary anxiety. Additionally, InsuranceDekho also offers complete tracking support for checking your policy status or downloading your policy document.

  • What documents are required while filing for a claim?

    The documents required while filing for a claim under a Health Insurance policy are the claim form, medical certificate, diagnosis report, ID proof, discharge card, prescriptions, bills, and FIR (in case of an accident).

  • What can be done if the claim is delayed or denied by Care Health Insurance?

    Contact an InsuranceDekho advisor for any problem during claim filing or settlement. The advisor will help you with your concerns at +91-7551196989 or support@insurancedekho.com.

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  • Multiple types of Health Insur...

    It was a smart move to get Care health insurance from InsuranceDekho. Their platform gave me comprehensive details regarding Care's policies, enabling me to make an educated decision. I like Care's broad range of coverage options and dedication to meeting client needs. The assistance I received from InsuranceDekho during the purchasing process was priceless in ensuring that my family and I had the appropriate coverage.

    S
    Care
    By Sunil Kumar
    On: Jul 02, 2024
  • Comprehensive Coverage and Opt...

    InsuranceDekho offered me a wide range of health insurance plans to choose from, catering to my specific needs and budget. I found Care Health Insurance which covers everything I was looking for at a reasonable premium.

    M
    Care
    By Muskan Jangra
    On: Jul 01, 2024
  • Great Assitance

    My family and I have benefited much from Care Health, and I am grateful to InsuranceDekho for their assistance in selecting the best plan for me. Their wide range of coverage options gives us much-needed protection against unanticipated medical expenses. Their commitment to client satisfaction and their round-the-clock service are impressive. I can rest easy knowing my family's health is adequately taken care of thanks to Care Health.

    V
    Care
    By Vishakha Vaid
    On: Jun 27, 2024
  • Best plan choice made through ...

    InsuranceDekho has completely changed my perspective on healthcare. They helped me get Care Health Insurance and their comprehensive plans provide coverage for a broad spectrum of medical costs. Their dedication to creating a simple and easy claim procedure is what I value most. Knowing that Care Health has my back and will help me financially in hard times gives me comfort.

    S
    Care
    By Shivika Singh
    On: Jun 25, 2024
  • Customising plan is simple

    It was easy to get Care Health Insurance with InsuranceDekho. My plan was easily customizable because of its user-friendly platform and kind service. I made sure I chose the finest choice for my needs thanks to the advice I received. I'm really happy with how simple the procedure was.

    P
    Care
    By Priya Aggrawal
    On: Jun 19, 2024

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