TATA AIG Health Insurance Claim Settlement Ratio, Process, Form

TATA AIG Health Insurance Claim Settlement Ratio

Tata AIG General Insurance Company earned an impressive claim settlement ratio of 86.5% in FY 2021-22, which indicates the insurer's ability to settle most of the claims it receives. Claim Settlement Ratio or CSR is the ratio of the total claims paid by the insurer versus the total claims received in a financial year. Since a CSR above 85% is considered good, it brings enough confidence to customers to buy Tata AIG health insurance plans.

The insurer also has a team of experienced claim settlement professionals who ensure timely settlement. Moreover, the company has established a user-friendly claim settlement process that ensures easy claim registration and settlement.

Claim Process of TATA AIG Health Insurance

Tata AIG General Insurance Company provides two types of claim facilities, i.e. cashless claims and reimbursement claims. The claim process for both are given below:

Claim Process for Cashless Treatment:

For cashless claim requests, the insured needs to get admitted at a network hospital of the insurance company. The claim process for cashless treatment is given below:

Step 1: Inform the Health Insurance Company

Notify Tata AIG General Insurance Company about your planned hospitalization at least 48 hours in advance and emergency hospitalization within 24 hours.

Step 2: Submit Cashless Claim Form

Submit the filled-out cashless claim form to the insurance company via post or email.

Step 3: Wait for the Approval Letter

The insurance company will verify all the details after receiving your cashless claim form. If approved, the hospital will be notified, and you will get a confirmation letter. The confirmation letter for cashless claims remains valid for seven days from the date of issuance.

Step 4: Submit the Letter to the Network Hospital

Once you get admitted to the hospital, you can submit the confirmation letter and the health card.

Step 5: Claim Settlement

Once you are discharged, the insurance company will pay all the bills directly to the hospital.

Claim Process for Reimbursement Treatment:

To get reimbursement for your medical expenses, you need to adhere to the following steps:

Step 1: Pay All the Hospital Bills

Before leaving the hospital after your treatment, crosscheck all the details and pay all the bills.

Step 2: Submit All the Documents

Soon after getting discharged from the hospital, you must submit all the required documents to the insurance company or the designated TPA along with the filled-out claim form.

Step 5: Claim Payment

Once the TPA or the insurance company receives all your documents, they will be verified and the claim payment will be processed within 21 days from document submission.

Documents Required for TATA AIG Health Insurance Claim

To get reimbursement for your medical expenses, here is the list of documents that you need to submit:

Duly filled and signed the claim form
Copy of your Tata AIG health insurance policy or health card
Medical certificate signed by the consulting doctor
Original hospital bills and payment receipts
X-ray and pathological reports
Copy of the hospital discharge card
Original pharmacy bills
Copy of the FIR in case of accidental claims
NEFT details of the policyholder
Duly filled CKYC form for claims above Rs 1 lakh
Disability certificate, if any

To know more details related to Tata AIG health insurance claim, you can speak to Policybazaar’s customer care team at 1800-208-8787 or write to 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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