Raheja QBE Health Insurance Claim Settlement Ratio, Process, Form

Raheja QBE Health Insurance Claim Settlement Ratio

Raheja QBE health insurance claim settlement ratio is a parameter to know the percentage of health insurance claims settled by Raheja QBE General Insurance Company during a financial year. The claim settlement ratio is derived by dividing the number of claims paid by the number of claims received in a financial year. The CSR is a good indicator of how likely the insurer is to settle your claim.

The Raheja QBE General Insurance Company has earned a claim settlement ratio of 95.8% for FY 2021-22. Besides, the insurer has a hassle-free claim process and ensures complete transparency.

How to Claim Raheja QBE Health Insurance?

Raheja QBE health insurance claim process is simple and smooth. Take a look at the procedure for both cashless and reimbursement claims below:

Raheja QBE Health Insurance Cashless Claim Procedure:

Read this step-by-step guide to know the Raheja QBE cashless claim procedure:

Firstly, get admitted to a nearby Raheja QBE network hospital.
Inform Raheja QBE General Insurance Company about your planned hospitalization in advance and emergency hospitalization within 24 hours.
Show your health card and a valid photo ID proof at the network hospital.
Fill out the pre-authorization form and give it to the doctor.
The hospital will send the pre-authorization request to the TPA.
The TPA will verify the documents and approve your cashless treatment.
Once your treatment is over, the TPA will pay the bill amount to the hospital. However, you will have to bear the co-payments, inadmissible expenses, and deductions.

Raheja QBE Health Insurance Reimbursement Claim Procedure:

To file Raheja QBE reimbursement claims, follow the process given below:

Notify the insurance company about your emergency hospitalization within 24 hours and planned hospitalization in advance.
Obtain the treatment and pay all the bills at the hospital.
Collect all the documents from the hospital at the time of discharge.
Fill out the Raheja QBE health insurance claim form and
submit it along with all the claim documents in original within 30 days of getting discharged from the hospital.
The insurer will verify all the documents and pay you the claim amount.

What are the Documents Required for Raheja QBE Health Insurance Claims?

The following documents need to be submitted to the insurer to file a reimbursement claim:

Duly filled claim form =signed by the insured and the treating doctor
Discharge summary from the hospital with the details of the treatment
Doctor’s consultation papers
Hospital bills with break-up along with interim bills payment receipts
Investigation reports like X-rays, blood reports, CT scans, sonography, MRIs, etc.
Copy of your health card
All pharmacy bills with doctor’s prescriptions
Invoices of the implant sticker, such as stent details in angioplasty, lens details in cataract cases, miscellaneous charges, etc.
FIR or Medico-Legal certificate for all accidental cases
Doctor’s referral letter advising hospitalization
Copy of the insurance policy
Death summary from the hospital
Indoor case papers
Death certificate/ post-mortem report
Inquest/Panchnama report
Disability certificate from the hospital or doctor
KYC details
NEFT details

Policybazaar exclusive benefits

30 minutes claim support*(In 120+ cities)
Relationship manager For every customer
24*7 claims assistance In 30 mins. guaranteed*
Instant policy issuance No medical tests*

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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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