SBI Health Insurance Claim Settlement

A policyholder can file a reimbursement claim at both, network and non-network hospitals. The steps in the reimbursement claim procedure include- 

• In case of planned hospitalisation, immediate intimation to SBI General
• In case of an emergency hospitalisation, the intimation should be given as soon as hospitalisation occurs 
• The policyholder is required to submit a claim form with the relevant documents within 30 days of discharge from the hospital 
• Once the investigation of the documents and claim form details is conducted, the letter of approval is sent to the policyholder by the claim management team of SBI General Health Insurance for confirmation of the approval. After verification, the claim is settled within 15 days
• If the claim is rejected, the insured is required to respond to the query raised by the insurer or insured to uncover the reason for rejection

The list of documents required for claim settlement at SBI General Health Insurance include- 

• Original investigation reports
• Pharmacy bills with prescription
• Final hospital discharge summary
• FIR or post-mortem report, if happened
• Original bills, receipts & discharge report
• Indoor case papers with duly-filled claim form
• Original hospital bills along with a valid photo ID proof
• Treating doctor's report and original consultation notes
• Nature of operation performed and surgeon's bill & receipt
• Test reports along with attending doctor’s or surgeon’s report

The Incurred Claims Ratio or ICR indicates the net claims paid by a health insurer as against the net premiums earned. ICR is a successful approach to find how suitable and reliable a health insurer is. ICR showcases the pace of claim procedure along with the productivity of the insurance firm, in terms of revenue. The incurred claim ratio of SBI General Health Insurance for FY 2018-19 is 52%, which showcases that SBI General Health Insurance has an ample amount of assets in hand and executing the claim process in a smooth manner.