Bajaj General Health Insurance Claim Settlement Ratio

Bajaj General health insurance claim settlement ratio indicates the claims settled by Bajaj General within a given time frame. Claim settlement ratio is important because a higher claim settlement ratio indicates the company’s reliability and prompt claim processing, instilling trust and reliability among policyholders. This ratio is calculated as the percentage of claims the company has paid against the total outstanding claims during a financial year.

Bajaj General Health Insurance Claim Settlement Ratio

The claim settlement ratio of 93.54% showcases the strong commitment to honoring the financial security of policyholders and their families in times of need. They have more than 18,400 network hospitals across India.  Established in the year 2000, the company has rapidly grown to become one of the prominent insurance companies in India.

Bajaj General Health Insurance Claim Settlement Processes

The company offers two types of claim settlement processes designed according to the needs of the customers:

• Cashless Claims
• Reimbursement Claims

Let’s look into each one of these in detail:

Cashless Claims:

These claims are simpler for the policyholder since they are quick and hassle-free, and do not require advance payments. The process for cashless claims with Bajaj Alliance is mentioned below:

• Step 1:

  Visit any of the Bajaj General network hospitals.

• Step 2:

  Once you notify the hospital about your health insurance, the hospital will send a filled pre-authorized form to the Health Administration Team (HAT) of Bajaj General.

• Step 3:

  After the company verifies all the submitted details, it will send the approval to the healthcare provider in 60 minutes. After this, you do not need to pay anything at the hospital.

• Step 4:

  If by chance the insurer needs some further information, they will send a letter to the hospital asking for relevant details. If the cashless claim is denied, you can still get treated at the hospital and later file for a reimbursement claim with all the necessary information at hand.

Reimbursement Claims:

Through reimbursement claims, the policyholder pays the hospital bills out of pocket before filing the claims with the insurer. The policyholder can visit any hospital of his choice and not necessarily the network hospital to get a reimbursement claim. The steps for filing a reimbursement claim with Bajaj General are as follows:

• Step 1:

  After the completion of your treatment, collect all the documents and submit them to the Bajaj General General Insurance Company Limited - Health Administrative Team.

• Step 2:

  After the submission of the documents, the company will go through them and/or request for some more information from you if it is necessary or missing. If not, the company will initiate the claim via ECS within 7 working days.

• Step 3:

  If you are unable to provide the requested information, the company will send you 3 reminders after 10 days. If you are unable to respond post these 3 reminders i.e. 30 days the company will reject the claim.