Reliance Health Insurance Claim Settlement Ratio, Process, Form

Reliance Health Insurance Claim Settlement Ratio

Reliance General health insurance claim settlement ratio has been consistently good over the years, which makes it a great choice to buy health insurance online. The Claim Settlement Ratio (CSR) refers to the number of claims settled by the insurer as compared to the total number of claims received in a fiscal year. Generally, a CSR of more than 85% is considered ideal.

In FY 2021-22, the Reliance health insurance claim settlement ratio is 95.3%, showcasing that the insurer is trustworthy and can quickly settle all your claim requests. Moreover, the round-the-clock accessibility to insurer claim support is an added advantage.

Claim Process of Reliance Health Insurance

Reliance health insurance policyholders can either raise a cashless claim or a reimbursement claim. While lodging a claim with Reliance General Insurance Company, make sure that you have the following details handy:

Reliance medical insurance policy number
Contact details of the policyholder (contact no., email id, address, etc.)
Name of the person who is admitted to the hospital
Relationship with the hospitalized person
Hospital name
Nature of the disease and the date of commencement of the symptoms
Nature of the accident, if applicable
Time, date, and location of the accident

Reliance Health Insurance Cashless Claim Procedure:

The process to claim cashless treatment expenses under Reliance health insurance plans is as follows-

Take admission in any of the Reliance General Insurance Company’s empanelled hospitals
Intimate the insurer about your hospital admission at least 2 days before a planned hospitalization and within 24 hours of an emergency hospitalization
Present your Reliance health card at the Third Party Administrator (TPA) helpdesk of the hospital
Submit the duly filled cashless request form to the TPA desk
The hospital will share your cashless request form with the RCare Health team, and you will get approval after review.
Sign all the bills at the hospital during discharge
The hospital will send the bill to the insurer, and the bill amount will be paid.

In case your cashless claim is rejected by the insurer, you must pay the bills from your own pocket while getting discharged from the hospital. Make sure to collect all the reports, bills, and other documents from the hospital and file a reimbursement claim with the Reliance General Insurance Company.

Reliance Health Insurance Reimbursement Claim Process:

Inform the insurance company about your planned hospitalization at least 2 days prior and emergency hospitalization within 24 hours
Get treatment at the hospital and pay all the hospital bills
At the time of discharge, collect all the reports, bills, and documents (in original)
Submit all the supporting documents to the insurance company within 15 days of hospital discharge
The insurer will verify your documents and accordingly, pay you the claim amount.

Documents Required for Reliance General Health Insurance Claim

Here is a checklist of the documents that you need to submit while filing a claim for Reliance health insurance plans:

Daycare Treatment/Hospitalization:

Claim form filled and duly signed by you
Doctor’s prescription stating the onset of the symptoms
Medical treatment papers
Diagnostic reports (like ECG, X-ray, etc.)
Original receipts and medical bills
Ambulance bill/receipt
Discharge card from the hospital (original)
In accidental cases, a copy of the FIR is required
Cancelled cheque
A copy of the Reliance Health card
Xerox copy of PAN card/ID card

Domiciliary Hospitalization:

Reliance medical insurance claim form ( duly filled & signed)
The first prescription from the doctor (stating the date of the onset of the symptoms of the illness)
Doctor’s prescription and healthcare treatment papers
Medical investigation reports
Receipts and original medical bills
FIR report (in case of an accident)
Certificate from the medical practitioner recommending the treatment at home
Documents proof showing lack of accommodation in the nursing home/hospital
ID card
A cancelled cheque

Critical Illness Claims:

Claim form
Doctor’s certificate with the diagnosis of the illness (stating the initial symptoms)
Radiology reports, pathology reports, and other investigation reports
Original receipts and hospital bills
Chemist bills
Hospital admission and discharge card/ certificate
Cancelled cheque/1st page of passbook
Identification card

To know more about health claims, you can call our helpline number at 1800-208-8787. You can also email us at care@policybazaar.com.

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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