Claim Settlement Ratio of Tata AIG Health Insurance – A Complete Guide

Buying a health insurance policy is one of the most important investments that a person must plan early on in life. And before you buy a health plan, the first thing to look for is the claim settlement ratio of the insurance company. Let’s take a look here:

It is very crucial to check the claim settlement ratio of the insurer that you are planning to buy your health insurance from. Claim Settlement Ratio or CSR is something that you cannot ignore when it comes to your health plan. Like in the case of buying a new asset like jewellery, house, car etc., when you do a lot of research and check the asset in terms of all parameters, buying an insurance policy also needs the same level of research and consideration including checking the CSR.

If you buy a health plan from an insurer who is unable to comply with your claim request when required, the plan would be useless for your family and yourself. In such cases the monetary burden will come to you and your family. Hence, it is very important that you purchase a health insurance policy from a reputed insurance company with a good claim settlement ratio. You must also do a thorough research and evaluate the performance of the company in terms of various parameters and check if it is good enough to trust with your and your family’s health.

In this post, we will learn about the claim settlement ratio of Tata AIG Health Insurance company and know about its claim settlement process.

Tata AIG Health Insurance at a glance

Features	Details
Network Hospitals	7000+
Claim Settlement Ratio	96.43% (FY 2020-21)
Renewability	Lifelong
Waiting Period (Pre-existing diseases)	4 years

 

What is the Claim Settlement Ratio?

Claim settlement ratio of a health insurance company confirms the capacity of the insurer to settle claims of the policyholders. The CSR rates a particular insurer based on its claim settling ability. If the CSR is high, it means that the company is capable of settling claims better and if the CSR is low, it means that the company may not have a good background on settling claims.

As per IRDAI or Insurance Regulatory and Development Authority of India, the CSR of Tata AIG health insurance company is 96.43% for FY 2020-21.

Tata AIG Health Insurance Claim process

Now, let us take a look at the process of claim settlement of Tata AIG. The Tata AIG claims like any other health insurance policy can be raised via two ways: cashless claims and reimbursement claims

1. Cashless Claims 

• For cashless claims, the insured has to get admitted in a network hospital of the insurer that is empanelled with the company
• To know the empanelled hospitals of the insurer, you can visit their official website.
• Once in the network hospital, you must validate your identification at the helpdesk of the hospital. When that is done, the hospital sends the pre-authorised form to your insurer
• Tata AIG will review the request form and confirm it after completing the formalities
• The insurer will send an email to the hospital and will share one copy with the insured as well
• Once the treatment is done and the patient is discharged, the insurance company will make payment to the hospital to settle the amount of claim after complying with the formalities
• You must note that you have to inform the insurance company of the hospitalization at least 5 days prior to your planned hospitalization for Tata AIG claim intimation and within 24 hours if it is an emergency hospitalization

 2. Reimbursement Claims 

In the reimbursement process of raising claims, all the bills of treatment are required to be paid by the insured at the time of discharge from the hospital. Later the insured can raise the claim as reimbursement from the insurance company.

• For raising reimbursement claims, the insured must keep all the bills, papers, doctor prescriptions etc., and submit them together with the application of claim to the insurer
• Once submitted, the insurance company will analyse your claims and may ask for any other document if required
• Once everything is done and approved, the insurance company will send the claim amount to your account directly
• If the claim is rejected, they will state you the Tata AIG claim status with reasons