SBI Health Insurance Claim Settlement

By dividing the total number of claims settled within 30 days by the total number of claims paid, SBI Health Insurance calculates its claim settlement ratio. The claim settlement ratios for the preceding five years are listed below:

The claim settlement ratio (CSR) of an insurance company is a crucial factor to take into account when choosing a provider of health insurance. CSR assists you in evaluating the company's claim-settling capacity, which is vital for you and your loved ones. The importance of CSR can be attributed to two key factors:[2]

• Assists in Evaluating Insurance Companies: You must take the insurer's Claim Settlement Ratio (CSR) into account when purchasing a health insurance policy. CSR is a statistic that can assist you in deciding if insurance is right for you or not. You should evaluate the CSR of several businesses to determine which has the highest ratio before making a purchase. Should the need arise, you are more likely to get a claim from an insurer with a higher claim settlement ratio.

• Displays the Percentage of Claims that the Insurer has Paid Out: When determining an insurer's level of dedication, a high claim settlement ratio is crucial. An insurer is more likely to resolve claims when policyholders need them, according to a high settlement ratio. But if the insured doesn't submit the required paperwork, the claim can be denied, which would lower the insurer's claim settlement ratio.

The steps listed below should be followed if you need to submit a claim to SBI Health Insurance:

How To File a Claim

Step 1: Initiation

• In the event of an emergency or when scheduling a medical appointment, get in touch with InsuranceDekho or SBI Health Insurance customer service right away.

To file a claim for SBI Health Insurance policy, you need to fill out two sections of the form. The following is a list of the separated information:

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 canceled cheque

13. KYC Form

Through SBI Health Insurance, around 7500 healthcare facilities provide cashless services. SBI Health Insurance must be notified 48 hours in advance of any planned procedures at non-network hospitals, or within 48 hours following the patient's admission in the event of an emergency. Notably, fulfillment with the conditions specified in both the hospital's and your SBI Health Insurance policy is necessary for authorization for cashless care in non-network hospitals.

In addition, the following is a list of what to do in the event of cashless and reimbursement claims:

Cashless Claims

• Head to the nearest SBI General Network Hospital medical facility.

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

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

• Once everything is approved, the claim executive will review the reports and go forward with the claim's processing.

• As soon as you have approval, you can start therapy in the hospital.

• After treatment, the hospital and your insurance company will pay the amount together.

Reimbursement Claims

• Notify SBI Health Insurance of your hospital stay (if it is scheduled, 48 hours in advance; in case of an emergency, within 48 hours).

• Pay your hospital bills in full and submit the necessary documentation.

• Fill out the claim form and send it in.

• Await the approval and status report from the insurer.

Keep in mind that you must:

• Within 15 days of discharge, submit your claim form and all supporting documentation.

• Keep all duly signed documents ready for submission to guarantee a smooth claims process.

To find out the status of your SBI Health claim, follow these steps both online and offline:[1]

Online:

• Go to the official SBI Health Insurance website.

• On the header, select the "Claim" sub-header.

• The claim page will be displayed to you.

• To verify the status, enter the information.

Offline:

• When you visit the SBI Health Insurance location nearest you, submit a copy of your insurance documentation.

• Speak with a branch office executive who can assist you in determining the status of your claim and your coverage.

You can also get the update by calling any number on the list provided on the SBI Health Insurance website, or by providing your claim reference number to the customer service representative over the phone at 1800 210 3366, a toll-free number.

According to the Insurance Regulatory and Development Authority of India (IRDAI), an insurer usually needs 30 days to resolve a claim after the date of payment or the filing of claim paperwork.

Tips to Get Your Claim Settlement Faster

Keeping the following in mind can help to speed up the settlement of your claims:

• Develop a deeper understanding of your policy.

• Only send completed documents.

• All of your correspondence with your insurer should be kept on file.

• Continue to implement the policy.

• Go over each paper you have in detail.

• Speak with a lawyer if required.

To receive help and support with your claim from InsuranceDekho, you can:[3]

• Email:sbig.health@sbigeneral.in

• Contact No:1800 210 3366

To receive help and support with your claim from InsuranceDekho, you can:[4]

• Email: support@insurancedekho.com

• Contact No: +91-755 1196 989.

[1]https://www.sbigeneral.in/health-insurance/

[2]https://www.sbigeneral.in/blog-details/health-insurance-claim-settlement-ratio

[3]https://www.sbigeneral.in/claim