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ManipalCigna Health Insurance Claim Settlement

ManipalCigna Health Insurance is part of Manipal Group, the largest healthcare provider chain in India. Manipal has served over 18million+ customers and has serviced 14.25 claims. ManipalCigna is present in 600+ cities and 77 branches across India. ManipalCigna has settled 94% cashless approval within 2 hours with a claim settlement ratio of 93.40%. ManipalCigna has a 8900+ network hospitals and it has a tie-up with Cigna, the largest healthcare provider with an experience of 225+ years.

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Claim settlement Ratio of ManipalCigna Health Insurance

The claim settlement ratio of ManipalCigna Health Insurance is derived by dividing the total claims settled by the total claims received X 100. For Example, if a company has received 10,000 claims and from that they have settled 9,500 claims then the CSR will be (9,500/10,000*100) 95%.

The claim settlement ratio for the year 2023-24 of ManipalCigna health insurance is 99%.

Why is Claim Settlement Ratio Important?

The claim settlement ratio plays an important role in choosing health insurance, it is the metric which shows the ratio of claims approved and settled by the insurer. CSR shows the company's ability to pay claims to its customers in a given fiscal year.

You should compare the CSR of different companies before buying any policy and choose the health insurance company with a high claim settlement ratio. A high claim settlement ratio shows that the company is paying claims to its customers when they need it.

ManipalCigna Health Insurance Claim Initiation

Please follow the below-mentioned steps to file a claim with Manipal Cigna Health Insurance:

How To File a Claim

Step 1:- Initiation

Initiate your claim by reaching out to ManipalCigna Health Insurance or InsuranceDekho and inform them about your pre-planned appointment or emergency hospitalisation.

  • You can contact ManipalCigna support atcustomercare@manipalcigna.com or give the ManiplCigna Health Insurance customer service team a call at their toll-free number 18001024462.[1]
  • To reach an InsuranceDekho representative, please call our customer support number 7551196989 or send us an email at support@insurancedekho.com

Step 2:- Verification

Verification of the document will be done by the claim team of ManipalCigna Health Insurance. After verification if everything is right and according to the terms and conditions of the company then your claim will be processed.

Step 3:- Tracking

You can track your claim by visiting the website of ManipalCiga and you can know the status of your claim from there. You may also contact the customer support agent of InsuranceDekho.

Details to be Filled in the ManipalCigna Health Insurance Claim Form

There are two forms which are to be filled out before filing the claim with ManipalCigna Health Insurance and the below-listed details are required in both forms:[2]

Part A

Part B

Details of Primary Insured

Details of Hospital

Details of Insurance History

Details of The Patient Admitted

Details of Insured Person Hospitalised

Details of Ailment Diagnosed (Primary

Details of Hospitalization

Details of Ailment Diagnosed (Primary)

Details of Claim

Claim Documents Submitted - Checklist (Only Fill in Case of Non-Network Hospital)

Details of Bills Enclosed

Declaration By The Hospital: (Please Read Very Carefully)

Details of Primary Insured’s Bank Account


Declaration By Insured


Claim Process of ManipalCigna Health Insurance

ManipalCigna has a 8700+ network hospitals in which you can get cashless treatment and in non-network hospitals, you will get reimbursement from the insurer after filing the claim. There are procedures for filing both cashless and reimbursement claims which you will get to know from the below points.

Cashless Claim

To file a cashless claim follow these steps:[3]

STEP 1:

For planned hospitalisation inform your insurer before 48hrs of admission.

For emergency hospitalisation inform your insurer within 48 hrs after admission.

STEP 2:

Go to the hospital desk and ask TPA for a cashless hospitalisation form and fill it out.

STEP 3:

After filling out the form TPA will verify your documents.

STEP 4:

After document verification, if everything is fine then you will get access to cashless hospitalisation.

NOTE: Policy terms and conditions will be applied to benefits, inclusions and exclusions. Cashless or reimbursement claims will not be given, if you will go to the hospital which is excluded by the company.

Reimbursement Claim

To file a reimbursement claim follow these steps:

STEP 1:

Download Form A and Form B from the ManipalCigna website by clicking on the claim process.

STEP 2:

Fill out both the Forms according to the instructions given in it and attach the required documents mentioned in it.

STEP 3:

Submit all the documents by visiting the nearest branch of ManipalCigna.

STEP 4:

After verification of the documents given by you your claim process will start.

Once the process starts your reimbursement amount will be credited to your registered bank account.

ManipalCigna 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.

ManipalCigna Health Insurance Claim Assistance and Support

To get support and claim assistance you can contact at the below-given details:

Retail Customers: 04068178534

Email: customercare@manipalcigna.com

To get claim assistance and support from InsuranceDekho you can:

  • Email:- support@insurancedekho.com
  • Contact No:- +91-755 1196 989.

Reference

  1. Reimbursement & Cashless Claim Process | ManipalCigna[1]
  2. Reimbursement & Cashless Claim Process | ManipalCigna [2]
  3. Reimbursement & Cashless Claim Process | ManipalCigna[3]
  4. Track Your Health Insurance Claim Status Online | ManipalCigna[4]
  5. Retail Customers: 04068178534

Health Insurance News

FAQs

  • What is a reimbursement amount?

    It is the amount paid back to you by the insurance company for admissible medical expenses you have incurred.

  • What is planned hospitalisation?

    When you plan your treatment in advance, it is called planned hospitalisation. The intimation of such hospitalisation should be given a minimum of 3 days before the date of hospitalisation.

  • What is a cashless claim? Please explain.

    In a cashless claim, you need not to pay any amount to the hospital for getting admission and availing treatment. To avail cashless treatment, get medical treatment at network hospitals of ManipalCigna. 

  • Is cashless claim treatment available at ManipalCigna?

    Yes, cashless claim treatment is available at ManipalCigna. To get this benefit, you need to avail treatment at a ManipalCigna network hospital. 

  • What is the reimbursement claim?

    Reimbursement claim means ManipalCigna refunds all the amount incurred during the treatment at a non-network hospital. This is applicable when you don’t find a network hospital in your city and choose to seek treatment at a non-network hospital by paying hospital bills and other amounts from your pocket. After getting discharged, you will need to send all the documents to ManipalCigna to receive the amount. 

  • What are the documents required for reimbursement claims at ManipalCigna?

    The list of documents you need to send to ManipalCigna for a reimbursement claim is original hospital bills, original discharge summary, other reports like medicine bills along with the prescription, test reports, attending physician’s reports, surgeon’s reports, etc. and follow-up checkup reports if you have any.  

  • Is cashless facility available in all cities of India?

    To know the right answer, we advise you to visit the official website of ManipalCigna wherein you will find a list of network hospitals. Or you can contact us anytime at our toll-free number 7551-196-989. 

  • How to calculate the Claim Settlement Ratio (CSR) of ManipalCigna Health Insurance?

    To calculate the Claim Settlement ratio of ManipalCigna Health Insurance, you can use the formula given below:
    Claim Settlement Ratio=(Total claims settled or paid)/(Total claims received+Outstanding claims at the beginning of the year).

  • How to process cashless insurance claim settlement of ManipalCigna Health Insurance?

    To process cashless claim(s) under ManipalCigna Health Insurance, you are required to follow the steps given below: 

    • Intimate ManipalCigna Health Insurance 3 days prior to admission in case of planned hospitalisation and within 24 hours of hospitalisation in case of emergency hospitalisation 
    • Show your health card and a valid photo ID at the network hospital 
    • Your documents will be verified by the insurance company 
    • If the claim has been made in accordance with the terms and conditions under the policy, then the insurer will settle the bill directly at the network hospital. 
  • How to make reimbursement claims under health insurance plans offered by ManipalCigna Health Insurance?

    To make a reimbursement claim under ManipalCigna Health Insurance, you are required to follow the steps given below:

    • Intimate ManipalCigna Health Insurance about the treatment
    • Avail the required treatment at the non-network hospital of your choice and pay the bill from your own pocket
    • Submit the claim documents to the corporate office or the nearest branch of ManipalCigna Health Insurance 
    • The insurance company will verify your documents and pay for the treatment if the claim made by you is in accordance with the terms and conditions of your policy
  • What is the time frame within which the hospitalisation must be reported to ManipalCigna Health Insurance?

    In case of planned hospitalisation, you must convey ManipalCigna Health Insurance 3 days in advance by contacting them on the toll-free number 1800-419-1159. Whereas, in case of emergency hospitalisation, the insurance company should be informed on the same number within 24 hours of hospitalisation. 

  • What is the Claim Settlement Ratio of ManipalCigna Health Insurance?

    As per the IBAI’s General Insurance Claim Insights Handbook For Policyholders-5th Edition, the Claim Settlement Ratio of ManipalCigna Health Insurance for the financial year 2019-20 is 85.72%. 

  • Whom should I contact for claim intimation and settlement?

    You can notify either InsuranceDekho or ManipalCigna directly by calling on their customer care numbers for planned or emergency hospitalisation. FYI, InsuranceDekho's toll-free number is 7551196989

  • What is the time limit for claim submission in the case of the cashless facility?

    You need to submit the claim within 15 days from the date of discharge from the hospital.

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    I chose InsuranceDekho because of its reputation for being trustworthy. They are partnered with reputed insurance companies, giving me peace of mind about my coverage. I purchased the ManipalCigna Health Insurance that has been great for me.

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    By Jasmin Kaur
    On: Jul 04, 2024
  • Helped secure my future with a...

    For my health insurance requirements, I chose ManipalCigna, and I'm really happy with my choice. I was able to quickly evaluate their plans and identify the best fit for me because of InsuranceDekho. Plans from ManipalCigna offer peace of mind because of their broad coverage and ability to be adjusted to meet my requirements. Their extensive hospital network guarantees that the best medical treatment is always available. Knowing that ManipalCigna has my back gives me comfort.

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    ManipalCigna
    By Mayank Gaur
    On: Jun 26, 2024
  • Helpful to find the closest ne...

    Impressed by Manipal Cigna's wide network of hospitals. Smooth claim settlement and good value for money. InsuranceDekho helped me locate the network hospital under Manipal Cigna’s network when I needed a hospital urgently. Thank you InsuarnceDekho for helping me in my times of need.

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    ManipalCigna
    By Mohd. Amaan
    On: Jun 10, 2024
  • Help received to locate the ne...

    Impressed by Manipal Cigna's wide network of hospitals. Smooth claim settlement and good value for money. InsuranceDekho helped me locate the network hospital under Manipal Cigna’s network when I needed a hospital urgently. Thank you InsuarnceDekho for helping me in my times of need.

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    ManipalCigna
    By Lakshay Chauhan
    On: May 28, 2024
  • InsuranceDekho helped clear my...

    InsuranceDekho convinced me to purchase health insurance online even though I was hesitant. Their portal made the entire process easier, and it was simple for me to compare various plans. I'm sure now that I made the best decision for my family and myself by buying the ManipalCigna health insurance.

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    ManipalCigna
    By Kunal Yadav
    On: May 28, 2024

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