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SBI Health Insurance Claim Settlement

Among India's leading health insurance providers, SBI Health Insurance was established in 2009. Employing over 7026 people who are dedicated to giving their customers a better, healthier future, the company has a claim settlement ratio of 95.04%. Over 10.91 crore clients certify the trust SBI health insurance has gained. SBI is a customer-focused company, as shown by its 95.04% claim settlement ratio.

This page includes information about SBI Health Insurance's claim settlement ratio, claim initiation, information from the claim form, and how to check the status of a claim. Visit the website or give customer support a call to find out the status of your claim. To prevent delays, include accurate information on the claim form. For help starting a cashless or reimbursement claim, get in touch with customer service.[1]



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Claim Settlement Ratio of SBI Health Insurance

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:

Fiscal Year

Claim Settlement Ratio

2023

95%

2022

88.4%

2021

88.4%

2020

66.08%

2019

66.08%

Why is Claim Settlement Ratio Important?

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.

SBI Health Insurance Claim Initiation

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



  • You may reach the customer support team at SBI Health Insurance by phone at their toll-free number, 1800 210 3366, or by email at sbig.health@sbigeneral.in.


  • Please contact us via email at support@insurancedekho.com or by phone at 7551196989 to speak with an InsuranceDekho representative.


Step 2: Verification


The claim team at SBI Health Insurance will examine all of your documentation as soon as it is received. The processing of your claim will begin if everything is in order.


Step 3: Tracking


To inquire about the status of your claim, please contact SBI Health Insurance's customer care. Contacting an InsuranceDekho customer care advisor can also help you receive updates regularly.


Details to be Filled in the SBI Health Insurance Claim Form

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:

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



Additionally, the following details are also required:
  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

Claim Process Of SBI Health Insurance

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.

How to Check the SBI Health Insurance Claim Status?

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.



SBI Health Insurance Claim Settlement Time

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.

SBI Health Insurance Claim Assistance and Support

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.

References

[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

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

Health Insurance News

FAQs

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

    SBI Health Insurance offers both cashless and reimbursement claim settlement options to their policyholders.

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

    Claims are resolved by SBI Health Insurance in 30 days or less.

  • Can I track the status of my claim online through SBI Health Insurance's website?

    Yes, you can track your claim status on SBI Health Insurance's official website.

  • What documents are required to file a claim with SBI Health Insurance?

    The following documents are required to file a claim, a copy of the claim intimation, original hospital bills, payment receipts, detailed hospital bill breakdown, and pharmacy bills.

  • What steps should I take if my claim with SBI Health Insurance is denied or delayed?

    If your claim is delayed, the first step you need to take is to get in touch with your insurance provider for a follow-up regarding your claim request.

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  • Customer service is great

    SBI Health Insurance has shown me to be a trustworthy ally during my medical journey. It was easy to go through InsuranceDekho's extensive coverage options and select the best plan for me. I appreciate their commitment to customer satisfaction and the kind, helpful personnel that is always on hand to handle my issues. I know my health is being taken care of with SBI Health Insurance.

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    By Vritti Singh
    On: Jun 27, 2024
  • Claim Process is straightforwa...

    Through InsuranceDekho, I was able to obtain SBI health insurance, and thus far, everything has gone well. The claims procedure is simple, and the coverage is comprehensive, covering a wide range of necessary health treatments. When I need support, the customer service staff is always there to help. I feel confident in my coverage and am overall extremely delighted with my purchase.

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    By Ujjwal Arora
    On: Jun 18, 2024
  • Simple and quick process with ...

    InsuranceDekho made buying SBI Health Insurance a breeze. I had no trouble comparing plans, thanks to their user-friendly interface and detailed information. The assistance I received was top-notch, guiding me every step of the way to ensure I made an informed decision. Overall, it was a seamless and satisfying experience.

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    By Anurag Shashwat
    On: Jun 18, 2024
  • Easy Claim Process

    I recently bought the SBI Health Insurance from InsuranceDekho and had an excellent experience with it. During challenging times, the straightforward and hassle-free claim submission process was a huge relief. Furthermore, their customer service representatives were always there to assist and direct me with any queries or issues I encountered.

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    By Nikita Agarwal
    On: Jun 06, 2024
  • Comparing health insurance mad...

    Finding insurance was made simple by InsuranceDekho! After entering my information, I was presented with a list of possibilities. I got the finest deal when I purchased security for my family and myself because SBI health insurance covered us.

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    By Ria Chauhan
    On: May 29, 2024

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