Digit Health Insurance Claim Settlement Ratio, Process, Form

Digit Health Insurance Claim Settlement Ratio

Digit Health Insurance Claim Settlement Ratio is the ratio of the insurance claims settled by Go Digit General Insurance against the total claims received. CSR is calculated by dividing the number of claims paid by the number of claims received during a fiscal year multiplied by 100. The Digit health insurance claim settlement ratio is 84.6% for FY 2021-22.

The Go Digit General Insurance enjoys a claim settlement ratio of above 80%, which is considered good. Thus, it indicates that the insurer settles most of its claim requests. Moreover, the insurer has a dedicated team for claim settlement.

Claim Process of Digit Health Insurance

A health insurance claim is the official request to get your healthcare and medical costs covered by the Go Digit General Insurance. If you have a Digit health insurance policy, then you can file both cashless and reimbursement claims. Take a look at the claim process below:

Claim Process for Cashless Treatment:

Check out the steps given below to file cashless Digit health insurance claims:

Step 1: To file a claim, you need to give intimation to Go Digit General Insurance at least 48 hours before your planned hospitalization or within 24 hours of getting hospitalized for emergency treatment.

Step 2: Furnish your e-health card and get the pre-approval form from the Insurance helpdesk/Mediassist at the network hospital.

Step 3: Now fill & sign the form and submit it at the helpdesk

Step 4: If everything goes fine, the insurer will authorize your cashless treatment. You can go ahead with the medical treatment. The treatment must be availed within 15 days of getting the approval.

Step 5: After your discharge, your network hospital will share the bills with Go Digit General Insurance, and the insurer will settle the bill directly.

Claim Process for Reimbursement Treatment:

For reimbursement claims, you need to follow the process given below:

Step 1: You need to inform the insurer about your emergency hospitalization within 24 hours and planned hospitalization at least 2 days in advance. The insurer will give you the link to upload the soft copy of all the original documents like reports, bills, etc. and the NEFT details of your bank account.

Step 2: You must pay all the bills while getting discharged from the hospital and collect all the documents.

Step 3: You need to sign all the documents before uploading them. Do not forget to write ‘For Digit Insurance’ on the documents. Keep all the original documents handy for future reference.

Step 4: You need to upload the documents within 30 days from the date of getting a discharge from the hospital.

Step 5: The Go Digit General Insurance will make the payment within 30 days of receiving all the documents.

Documents Required for Digit Health Insurance Claim

Here is the list of documents required to file a Digit health insurance claim:

List of Documents	Hospitalization Claim	Critical Illness Claim	Daily Hospital Cash Claim
Claim form duly filled and signed	✔	✔	✔
Hospital discharge summary	✔	×	✔
Medical Records (Optional documents may be asked on a need basis: OT notes, case papers, PAC notes, etc.)	✔	✔	×
Original hospital bill	✔	×	×
Original hospital bill with break-up	✔	×	×
Original pharmacy bills with prescriptions and investigations outside the Hospital	✔	×	×
Investigation papers and consultations	✔	✔	×
Digital Images/CDs of the Investigation Procedures	✔	×	×
A cancelled Cheque, KYC (Photo ID Card) and Bank Details	✔	✔	✔
For maternity claims- Birth discharge Summary & Ante-natal Record,	✔	×	×
In case of accidents- MLC/FIR Report	✔	✔	×
Post Mortem Report, Disability/Death Certificate, Original Invoice/Sticker (If applicable)	✔	×	×
Attending Doctor’s Certificate	✔	✔	×

For any queries related to health insurance claims and the Digit health insurance network hospitals list, you can visit Policybazaar.com or speak to our customer care team.

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Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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