When you buy any insurance, it is essential to check the claim settlement ratio and process with other important details of the company. The TATA AIG health insurance has bagged an impressive claim settlement ratio in FY 2021-22 of 86.5%. Keep reading to get more details about it.
TATA AIG Claim Settlement Ratio
The claim settlement ratio determines the percentage of paid claims to the claims filed by the insurance company. It is one of the primary factors that an insurance seeker looks into the insurance company. It tells you whether the company will be able to settle your claims at the time of need.
Therefore, while buying any insurance, people check the claim settlement ratio, and in health insurance, it becomes highly essential as in any emergency you will need the funds immediately.Â
TATA AIG Health Insurance Company has earned a splendid claim settlement ratio. In FY 2021-22, the company earned a claim settlement ratio of 86.5%. In FY 2020-21, the company acquired a claim settlement ratio of 96.43%.Â
| Period of the Number of Claims Paid | Claim settled (FY 21-22) |
| <3 months | 93.5% |
| 3 to 6 months | 3.97% |
| 6 months to <1 year | 1.9% |
| 1 year to <3 year | 0.45% |
| 3 years to <5 years | 0.07% |
| 5 years | 0.06% |
TATA AIG offers a customer-friendly claim process for its customers, so it will be easy for them to claim insurance at the time of emergency.
TATA AIG Health Insurance Claim Process for Cashless Treatments
The TATA AIG claim process for the cashless claims will be processed without paying any single penny in the hospitals networked with TATA AIG. Tata AIG has 9386 network hospitals nationwide, you can check the list of TATA AIG hospitals on the official website.
To avail the benefits of a cashless claim, follow the below steps:
- Go to the TATA AIG networked hospitals near you in the city.
- Now, notify the insurer 48 hours before your plan hospitalization and within 24 hours for emergency hospitalization.
- When you visit the hospital, make sure you have your photo identity proof and TATA AIG cashless card.
- Â Submit the cashless claim form to the insurance department or desk of the hospital.
- Your pre-authorization will be reviewed by the TATA AIG when the hospital sends your pre-authorization request after reviewing your identity and form.
- Â Now, you have to wait for the approval of the insurance. The insurer will review your application, if they approve the cashless claim, they will inform the network hospital and the policyholder via email.
- After all the formalities are done and approved by the insurer, your hospital bill will be cleared by the TATA AIG company after you get your discharge.
Claim Process for the TATA AIG ReimbursementÂ
Policyholders who got admitted to non-network hospitals can claim their reimbursement of the expenses of the treatment. Follow the below steps to claim the reimbursement for the treatment:
- Once you get discharged from your respective hospitals to settle the medical bill, contact your designated third-party insurer (TPA) or the insurance company.
- Collect all your required documents related to your treatment at the non-networked hospital and submit them to the TPA or the insurance company.
- The insurer will review your documents after the submission, so be patient during the process.
- Once the insurer finds your claim valid, they will approve it and pay the reimbursement according to the terms and conditions mentioned in the insurance policy.
Documents required to Claim the TATA AIG Health Insurance
The policyholder will need the following documents in hand while claiming the reimbursement of the hospital’s bills:
- The discharge summary of the hospital.
- Your medical certificate is signed by your consulting doctor.
- Your claim form is filled with all the required information.
- The bills and receipts of your hospitals including your payment receipts.
- Your pharmacy bills along with the prescription and payment receipts.
- If you are claiming accidental claims, you need to present the FIR related to the accidents. You will need to show the post-mortem report if death happened during the treatment.
- Your test reports, such as X-ray, ultrasound, etc.
- Details of the operation performed and the bill of the surgery with the payment receipts.
- Canceled cheque or your NEFT details.
The claim settlement ratio is one of the deciding factors for people before taking any insurance. Hence, always stay updated with the CSR of your insurer.Â