Monday, 4 June 2018

How to File a Claim with Star Health & Allied Insurance?

The litmus test for any insurance health insurance company is when you make a claim for hospitalisation or other medical expenses covered under your insurance policy. 

The claim procedure should be hassle free and settlement must be within a reasonable time or as per the terms of the policy. Nothing is more frustrating for a policy holder than for him to run from pillar to post trying to settle a claim after the trauma of an illness and stay in a hospital.

Apart from looking at the amenities and other terms and conditions, it is also important to know how easy it is to deal with the claims departments and fast they clear your claims. Preferably, every insurance company must have a well trained and cooperative customer service support that guides you prior to hospitalisation or within a couple of days. It is their responsibility to guide you on the procedures required, documents required which have to be produced while making a claim.

Star Health Insurance Prompt Claims Disposal

Customer Centric Service is one of the main tenets in the Star Insurance’s Citizens Charter. In the past few years they have carved out a name for themselves not only for honestly dealing with all policy holder grievances but also clearing all claims in record time.

Star Insurance has a track record of settlement in the shortest time. They have cleared 87% of cashless claims within two hours from discharge. They have settled a total of 3,78,710 claims amounting to ₹ 1,378 Crores for the financial year 2016/ 2017.

Star Heath Claims Support is a customer friendly and hassle free process. They ensure that all settlements are made in a timely and just manner. The key components of their service are courtesy, speed, attention and the drive to work hard to meet and exceed customer expectations.

Contacting and Intimating Star Health Insurance

The policy holder or someone known to the patient must Intimate Star Insurance Company within 24 hours from the illness or accident.  This can be done by contacting their toll free number 1 800 425 2255 or the nearest Star Health Mediclaim office. Please keep the policy number and Star Health card number handy while making the call.

Types of Claims 

Star Health has two types of claims viz. Cashless Claims and Reimbursable claims:

Cashless Claims are made when the policy maker is treated in one the insurance company’s network hospital. Identify yourself as a policy holder with your Star Health ID card at the hospital admissions reception. The hospital will ask Star Health for authorisation after which you will be admitted for treatment and all expenses related to this hospitalisation will be borne by Star Insurance. In this case, the following documents must be handed over to Star Insurance;

            Copy of Health Card issued by Star Health

            Claim Form duly filled with all details
            Medical case papers issued by treating doctor
            Investigative reports (X-ray, blood analysis, MRI etc)
            Pharmacy bills supported by doctors’ prescription
            FIR or MLC (Medico Legal Certificate) in the case of accident
            Discharge Summary
            Other papers pertaining to your treatment

Reimbursement Claims are made when the policy holder is treated in a hospital not listed in the Company’s network of hospitals. You need to follow the procedure as detailed below:
Information regarding your illness must be intimated to the customer support   (toll free number)

Complete the form (can be downloaded from the company website) and
Include the following ORIGINAL documents:

          original bills, receipts and discharge card from the hospital
          Bills from pharmacist with the supporting prescription from the doctor
          Receipts of tests done during the period of illness
          Investigation test reports along with the requisition note from the  
          medical practitioner or surgeon prescribing the test(s).
          Details of surgery and surgeons bill and receipt
          Certificate from treating Doctor
          Self declaration or FIR in case of an accident
          Health registration certificate, if the hospital has less than 15 beds.

How to Claim Reimbursement

The claiming process is fairly simple and straight forward. After you have paid the bills of all expenses incurred, you will fill the claims form and send it to the closest Star office combined with all the documents mentioned above. Your entitlement will be cleared within the shortest possible time as per the policy terms and conditions.

Related : Claim Procedure for Star Health Insurance

Some Points to Remember While Making a Claim

If the form is incomplete, the authorisation request can be cancelled.
Non Reimbursable items will be borne by the insured
All claims must be submitted no later than 30 days from the date of discharge
Post hospitalisation claims have to be submitted within 30 days from discharge. 
About Star Health Insurance

Star Health and Allied Insurance is the first standalone insurance company covering personal accident, mediclaim and overseas travel insurance. It is headquartered in Chennai and was launched in 2006.

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