SBI Health Insurance Claim Settlement Ratio, Process, Form

SBI Health Insurance Claim Settlement Ratio

SBI Health Insurance claim settlement ratio has been consistent over the years, making it a great choice to buy health insurance. Claim Settlement Ratio (CSR) is a great way to judge if the insurer is likely to settle your claim. It can be calculated by dividing the total claims paid by the total claims received in a policy year multiplied by 100.

The SBI health insurance claim settlement ratio is 88.4% in FY 2021-22. Since a CSR above 85% is considered good, SBI General Insurance Company can be trusted to pay your health insurance claims on time.

Claim Process of SBI Health Insurance

Policyholders of SBI health insurance plans can choose to file reimbursement or cashless claims as per their convenience. Check out the procedure to file an SBI health insurance claim below:

SBI Health Insurance Cashless Claim Process:

Cashless treatment is possible at any of the network hospitals of the SBI General Insurance Company. The claim settlement process is given below:

Find the nearest network hospital in your area where you want to avail cashless medical treatment
Whether it is a planned hospitalization or emergency hospitalization, make sure to inform the insurer immediately and get your claim reference number.
Carry your SBI health insurance policy and cashless card to the network hospital.
Now, fill up the pre-authorization form and submit it to the network hospital.
The hospital will submit the form along with the required documents to the insurer for approval.
Your cashless treatment request will be reviewed by the insurer and you will be notified regarding the approval or rejection of the claim.
If you get approval for your claim, the insurer will pay for your treatment after you get discharged from the hospital.

SBI Health Insurance Reimbursement Claim Process:

A claim for reimbursement can be filed for treatments taken at both network and non-network hospitals. The process for filing reimbursement claims is given below:

You need to immediately inform the insurer in case of an emergency or planned hospitalization and obtain the claim reference number.
The SBI claims executive/manager will contact you within 24 hours and will give you the list of the required documents.
You need to submit the claim form along with all the required documents to the claims executive/manager. Make sure to get them verified against the original copies.
Your claim request will be reviewed, and you will be notified regarding the approval or rejection of the claim within 30 days of submitting all the documents.
If your claim has been approved, the insurer will pay the claim amount to you.

Documents Required for SBI Health Insurance Claim

Every claim is settled after the submission of the required medical documents and bills to the insurer. The list of documents required for SBI Health Insurance claims is given below:

Valid photo ID card
SBI health insurance claim form
Copy of health insurance policy
Doctor consultation letter and treatment advice
Pharmacy bills with prescriptions
Hospital discharge summary, bills and payment receipts
Diagnostic test reports with prescriptions
Death certificate and post-mortem report (in case of accidental death)

To know more about SBI health claims, you can call on Policybazaar’s helpline number at 1800-208-8787. You can email us at care@policybazaar.com.

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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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SBI Health Claim Settlement Ratio