Liberty Health Insurance Claim Settlement Ratio

Liberty Health Insurance Claim Settlement Ratio

Liberty health insurance claim settlement ratio for FY 2021-22 is 90.5%. The claim settlement ratio (CSR) indicates Liberty General Insurance’s ability to pay off your claim requests. Since the CSR is more than 85%, it implies that the insurer settles most of the claims it receives.

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Liberty General Insurance (LGI) is known for its quick and smooth settlement of claims. This has been made possible due to Liberty Health 360 – the in-house claim processing unit of the insurer.

Liberty Health Insurance Claim Process

With Liberty General Insurance, you can claim your medical expenses through both cashless and reimbursement procedures. Take a look at the process to file a Liberty health insurance claim:

Cashless Claim Procedure:

For cashless claims, the insured must take the treatment at a network hospital of Liberty General Insurance. To register a cashless claim with Liberty Health Insurance, follow the steps given below:

Step 1: You need to inform Liberty General Insurance about your emergency hospitalization within 24 hours and planned hospitalization at least 72 hours in advance

Step 2: Go to the TPA helpdesk at the hospital, fill out the pre-authorization form and submit it.

Step 3: The hospital will send the pre-authorization form to Liberty Health 360 for approval.

Step 4: Liberty Health 360 will verify the details and send an authorization letter to the hospital. The insurer can also ask for additional documents if required.

Step 5: Avail the treatment and pay for items & services not covered by the insurer during discharge. Make sure to verify all the bills and sign them.

Step 6: Once you are discharged, Liberty Health 360 will verify the documents shared by the hospital and pay the claim amount.

Reimbursement Claim Procedure:

To file a health insurance reimbursement claim with Liberty General Insurance, you need to follow the procedure given below:

Step 1: Notify the insurance company about your planned hospitalization at least 72 hours in advance and emergency hospitalization within 24 hours.

Step 2: Obtain the treatment and settle all the bills with the hospital while getting discharged from the hospital.

Step 3: Submit all the required documents to Liberty Health 360 within 7 days.

Step 4: Liberty Health 360 will crosscheck the documents and process the claim within 7 days of receiving all the documents. The payment will be made to you within 3 banking days.

Documents Required to File Liberty Health Insurance Claims

Given below is the list of documents required to file a Liberty health insurance claim:

For In-patient Treatment/ Daycare Procedure Claims:

• Duly filled and signed Liberty health insurance claim form
• Photocopy of current health insurance policy and a valid ID card
• Original daycare/discharge summary from the hospital
• Original hospital bill payment receipt with the receipt number
• First consultation letter, along with subsequent prescriptions
• Original bills, payment receipts, and reports of the tests suggested by the attending doctor/surgeon
• Certificate from the surgeon stating the nature of the operation along with the surgeon’s bills and payment receipts
• Certificate from the attending doctor/ specialist/ consultants/ anaesthetist, along with the bill and payment receipt
• Original invoice/bills for any implants, along with original payment receipts
• Doctor’s registration number & qualifications and hospital registration number & PAN details
• Original consolidated hospital bill with item-wise break-up
• Original chemist bills and payment receipts supported by prescriptions

For Road Traffic Accident Claims:

Apart from in-patient treatment documents, you must also submit:

• Copy of the Police FIR Report/Medico-Legal Certificate
• Certificate from the treating doctor providing details of the injury (For Medico-Legal cases)

For Accidental Death Claims:

• Copy of the Death Certificate/ post-mortem report (if conducted)

For Death Claims:

Apart from in-patient treatment documents, you must also submit:

• Original death summary from the hospital
• Copy of the Death Certificate
• Copy of the Legal Heir Certificate (if applicable)

For Pre and Post-hospitalization Expenses Claims:

• Duly filled and signed Liberty health insurance claim form
• Xerox of current Liberty health insurance policy and a valid ID card
• Original medicine bills and payment receipts supported by prescriptions
• Original consultation bills, prescriptions and payment receipts
• Copy of the hospital discharge summary
• Original test reports, bills and payment receipts supported by prescriptions

For Ambulance Claims:

• Duly filled and signed Liberty health insurance claim form
• Xerox of current Liberty health insurance policy and a valid ID card
• Original ambulance bill with payment receipt
• Treating doctor’s consultation prescription suggesting emergency hospitalization

For Reimbursement of Organ Donor Expenses Claims:

In addition to in-patient hospitalization documents, you need to furnish the following:

• Blood test or organ function test proving organ failure
• Treatment certificate from the hospital’s transplant surgeon

For any claim assistance, you can speak to Policybazaar’s health insurance customer support team and get your claims settled quickly.