These days, as soon as we get a job and start earning money, we try to put our money into some or other kind of investment. One of the investments that can save a lot of our money is a health insurance policy. There are very few people in the world who do not get illnesses. What if we are not one of them? Well, even when we get the best treatment in perhaps one of the best hospitals in the city, the thought of high medical bills keep bothering us. This is where a health insurance policy helps us. And if we go for a cashless health insurance policy, you just have to inform your insurer and everything will be taken care of.

Nevertheless, while choosing a health insurance policy, you must check the claim settlement ratio of the insurance company. This will give you a good idea of getting your claims during your treatment. One of the popular health insurance companies is the Chola MS General Insurance Company. As per FY 2018-2019, the Chola health insurance claim settlement ratio is 50.01%. This means the insurance company paid only 50% of the claim requests. If you have already bought a Chola MS health insurance plan, and now you want to file a claim, then you need to know about the claim process. Therefore, here is a guide for you:

For planned hospitalization

Once you have chosen a hospital from the list of network hospitals, you have to reach out to the insurance company 48 hours before you get hospitalized. You have to provide details or e-cards along with other documents such as photo ID proof issued by the Government of India at the Third Party Administrator desk of the insurance company.

Once the hospital validates the claim and the pre-authorization request is being sent to the insurer, the claim request will be reviewed by the insurance company. According to the policy terms and conditions, the claim request will be confirmed and then approved by the insurance company. The insurer will inform you as well as the hospital. And in case any additional documents related to the treatment are needed, the insurer will update you on that too. The claims will be settled by the Chola MS General Insurance Company at the hospital.

For emergency hospitalization

If it is an emergency, you have to inform the insurance company within 48 hours of being admitted to the hospital. You would be required to submit your health card and an ID proof issued by the Government of India. The claim request is first validated by the hospital and a pre-authorization request form is sent to the insurer. According to the policy terms and conditions, the insurance company will first review and then confirm and approve the claim. If there is any additional information or documents required by the insurance company, they will intimate the hospital accordingly. The claim will be settled by the insurance company at the hospital.

Important documents for Chola MS health insurance claims

The documents that you need to submit for a claim settlement are mentioned herein below:

  • The claim form which is filled as well as signed by you
  • Discharge card that has been issued by the hospital from where you received your treatment
  • A prescription of the doctor for hospitalization
  • Each of the medical bills, documents, and bills
  • Receipts of all the payments that you made
  • Prescriptions and the bills of medicines
  • Additional documents, if required

Once you know the process, it will certainly not be difficult for you to file your claim settlement. If you need more information related to claim settlement, you can visit the website of IIFL.