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National Health Insurance Claim Settlement

The claim settlement process at National Health Insurance Company Ltd. is quite easy and hassle-free. With thousands of network hospitals across the country, this insurance company boasts of its high numbers of claim settlement records through fast and easy claim procedures. The National Insurance Company lets you file claims in two scenarios: cashless and reimbursement.

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FAQs

  • When should I inform the company in case of planned hospitalisation for reimbursement of the treatment?

    You must inform the company at least 72 hours before the admission in case of planned hospitalisation to get reimbursement for the treatment. 

  • In how many ways does National Insurance settles claims?

    National Insurance settles claims in two different ways. These are-cashless and reimbursement. 

  • In how many hospitals can I enjoy a cashless treatment with National Insurance?

    National Insurance has over 6,000 network hospitals across India, where the policyholders can seek cashless treatment. 

  • What are the documents required for claim settlement with National Insurance?

    National Insurance requires the following documents for the claim settlement-

    • Duly filled claim form
    • Relevant cash memos and prescriptions
    • Certificate of diagnosis from the attending medical practitioner
    • Payment receipt in original along with the attending medical practitioner’s reports
    • Any other related documents as asked either by the company or the TPA
  • How to calculate the Claim Settlement Ratio (CSR) of National Insurance?

    Claim Settlement Ratio of National Insurance can be calculated using the formula given below:

    Claim Settlement Ratio = (Total no. of claims approved/Total no. of claims received) x 100

  • How to process cashless insurance claim settlement of National Insurance?

    To process cashless insurance claim under National Insurance plans, you must follow the steps given below:

    • Inform the National Insurance Company about the hospitalisation, before 72 hours in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation. 
    • Get a cashless claim request form from the insurance company or the insurance provider and submit it to the concerned person at the hospital. The hospital authorities will share the documents with the insurer. 
    • Your documents will be verified along with the pre-authorisation form. 
    • On the basis of documents submitted, the insurance company will make a decision on whether to accept or reject the claim request. 
    • The network hospital will then send the final request and settle the bills at the network hospital.
  • How to make reimbursement claims under health insurance plans offered by National Insurance?

    To make reimbursement claims under health insurance plans offered by the National Insurance Company, you must follow the steps given below:

    • Intimate National Insurance Company about the hospitalisation, before 72 hours in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation. 
    • Avail the required medical treatment and settle the bills out of your own pocket. Collect the documents related to your treatment, when leaving the hospital.
    • Submit the duly filled request form along with relevant documents to the insurance company.
    • Your documents will be verified by the insurance company and if the claim is made in accordance with the terms and conditions of your health insurance policy, then the company will pay you for the expenses incurred for the treatment.
  • What is the time frame within which the hospitalisation must be reported to National Insurance?

    In case of a claim under National Insurance plan, you are required to inform National Insurance Company 72 hours in advance in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.

  • What is the Claim Settlement Ratio of National Insurance?

    According to the IBAI’s General Insurance Claim Insights Handbook For Policyholders-5th Edition, the Claim Settlement Ratio of National Insurance for the financial year 2019-20 is 83.78%.

  • What is the Claim Settlement Ratio of National Insurance?

    As per the IRDAI (Insurance Regulatory and Development Authority of India), the Claim Settlement Ratio of National Insurance for FY 2019-20 is 83.78%. 

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  • Affordable Plan

    InsuranceDekho’s customer care executives advised me to buy the National Health Insurance Policy. I liked the policy benefits so I bought the National Health Insurance policy instantly online via a secured payment gateway. It was Affordable health insurance as per my needs. I am delighted to have bought it.

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    National
    By Tanuj Raghav
    On: Apr 02, 2024
  • Several Plans To Choose From

    InsuranceDekho has a huge variety of health insurance plans for everyone as per of their needs. I bought the National Health Insurance Policy at the InsuranceDekho portal and the Customer support team helped me understand all the policy benefits. I had a few doubts about the insurance plans which also they solved politely. Thank You All!

    P
    National
    By Pankaj Pal
    On: Mar 21, 2024
  • Anytime Support Facility

    I loved purchasing the National Health Insurance Plan from the online platform InsuranceDekho. I had a great time with the customer care executives of Insurancedekho company. Thank you to the insurance expert advisors for suggesting to me the National Health Insurance Plan.

    N
    National
    By Nagesh Yadav
    On: Mar 08, 2024
  • Digital Documentation

    I had a marvelous experience with InsuranceDekho. My purchase of National Health Insurance Plans was so convenient and easy. I am amazed at buying a national health insurance policy through online mode. It was so easy to compare the health insurance policies, do all the paperwork, and get protected with the health insurance. All the paperwork was done digitally without any problem. Thank You!

    M
    National
    By Manisha Sharma
    On: Feb 27, 2024
  • Digital Paperwork

    My purchase of the National Health Insurance Plan was very smooth. I bought this Health insurance policy from Insurancedekho’s online platform. What I liked the most was that I didn’t have to go anywhere and provide any hard copy documents all processes were online and secured. Thank you InsuranceDekho!

    P
    National
    By Parneet Kumar
    On: Feb 15, 2024