Iffco Tokio Health Insurance Claim Settlement Ratio

When considering an insurance company to buy insurance from, one crucial aspect to evaluate is its claim settlement ratio. It determines the number of claims paid by the company compared to the total number of claims filed in a given financial year. A higher claim settlement ratio implies a greater likelihood of having your claim settled promptly and efficiently.

Iffco Tokio Health Insurance Company, established in the year 2000, and counted among the oldest insurance companies in India, boasting a network of over 7000 hospitals. As per the latest annual report released by IFFCO TOKIO health insurance for the year 2023-24, Iffco Tokio Health Insurance has achieved commendable numbers reflecting their growth across all aspects. This reflects the company’s commitment to fulfilling its policyholders’ claims promptly.

Types Of Claim Settlement Process of Iffco Tokio

Iffco Tokio Health Insurance offers two types of claims filing processes to cater to the diverse needs of its customers:

• Cashless Claims
• Reimbursement Claims

Let’s delve into the details of each claim process.

Iffco Tokio Health Insurance Cashless Claims Process

Here’s a step-by-step overview of the cashless claim process for Iffco Tokio Health Insurance:

Step 1: To avail of the cashless treatment,visit the network hospitals of the company. Check for the list of the network hospitals on the website of the company.

Step 2: Notify the hospital 72 hours before the planned In case of planned hospitalization and 24 unplanned notify within 24 hours.

Step 3: Then the policyholder must fill all the information in the intimation form of the cashless treatment and submit it to the TPA.

Step 4: After receiving the duly filled claim form, the TPA will issue a pre-authorization letter in the name of the hospital.

Step 5: After the treatment, the policyholder will sign a discharge paper and settle all the non-medical expenses (if any)

Step 6: The hospital will send all the bills to the TPA and after receiving the documents the company will verify it and will settle the claim within 7 days.

Iffco Tokio Reimbursement Claims Process

In these claims, the policyholder pays the medical expenses upfront and then later makes reimbursement claims from the insurance company for the costs incurred. Iffco Tokio Health Insurance allows reimbursement claims to be filed for both network and non-network hospitals. Here’s an outline of the reimbursement claim process:

Step 1: The policyholder can undergo treatment at a network or non-network hospital.

Step 2: Essential documents, including the reimbursement claim form, must be submitted to the TPA/company within 30 days from the date of discharge from the hospital.

Step 3: After receiving the documents, the insurer will review them and then later approve them. If the claim is accepted, the payment will be transferred by the company directly to the policyholder’s bank account.