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Jan 08, 2025
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Health Insurance
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Star Health Insurance Claim Settlement Ratio IRDA, Claim Process, Documents Required
Star Health insurance claim settlement ratio is 99.06% and it is, therefore, considered to be a reputed insurance company that not only settles the maximum number of claims which are made on it but also offers a range of innovative health insurance products. Don’t miss to read this blog if you want to get higher claim settlement.
What is the Claim Settlement Ratio?
The ratio of claims that are settled by an insurer during a policy year as against the complete claims that the insurer receives during the year is called Claim Settlement Ratio (CSR).
Star Health Insurance Company Overview
| Features of Star Health Insurance | Specifications |
|---|---|
| Network Hospitals | 14000+ |
| Pre-existing diseases waiting period | 4 years |
| Claim Settlement Ratio (CSR) (2021-22) * | 99.06% |
| Policy Renewability | Lifetime |
Star Health Insurance Claim Settlement Ratio
Star Health and Allied Insurance Company Limited is a standalone health insurance company specialised in offering health insurance products to individuals. Besides offering health insurance plans for family, the company also offers personal accident and overseas travel plans which also cover medical contingencies suffered by the insured.
The company was formed in 2006 and ever since then it has been engaged in offering specialised and innovative health insurance plans to its customers.
When it comes to claims, Star Health Insurance Claim Settlement Ratio is good and allows a hassle-free claim settlement process where policyholders can get their claims settled easily and quickly. They just have to follow the prescribed claim process and the company settles their claims at the earliest.
The list of documents that are required to be submitted and the entire claim process is mentioned on the website of the insurance company itself.
| Age Analysis of Number of Claims Paid (%) | Claims Settled |
| Less Than 3 Months | 99.64% |
| 3 Months to 6 Months |
|
| 6 Months to 1 Year | 0.05% |
| 1 Year to 3 Years | 0.01% |
| 3 Years to 5 Years | 0% |
| More than 5 Years | 0% |
The claim settlement ratio is calculated and published by the Insurance Regulatory and Development Authority of India (IRDAI). It is calculated as the percentage of claims paid by the insurance company against the total claims made on it.
Thus, the claim settlement ratio’s formula is (claims paid / claims made during the year) * 100.
The higher the ratio the higher the claims insurance company has paid. a higher percentage is always better as it shows the insurance company to be trustworthy.
Star Health’s claim settlement ratio is 99.06% and it is, therefore, considered to be a reputed insurance company that not only settles the maximum number of claims which are made on it but also offers a range of innovative health insurance products. So, if you want to buy health insurance plan, choose Star Health and enjoy unique products and high claim settlement ratios.
Claim Process for Cashless Treatment
The policyholder of a Star Health Insurance can avail cashless claims only at the network hospital of the insurer. With an extensive network of 9,300+ hospitals in its network, Star health insurance allows its policyholders to enjoy maximum flexibility in terms of cashless claims.
Here are the steps to follow:
- Get admitted at a hospital near you that is listed in the network of Star Health insurance
- Inform the insurance company within 24 hours in case of emergency hospitalisation and within 2 days or 48 hours before getting admission if it is a planned hospitalisation
- Do not forget to carry the Star Health ID card and one photo ID proof with you to the hospital
- Now, you have to collect the form of pre-authorization that is available at the hospital counter. Submit the form at the hospital after filling it
- Once the hospital confirms your identity, they will send the request form to the insurer
- The insurer reviews the papers and approves it
- Once that is done, the hospital proceeds with the cashless treatment
- However, if the insurer denies cashless claim, then the policyholder can get the treatment done at the hospital, pay for it and later after getting discharged can file for a reimbursement claim
How to Check Star Health Insurance Policy Claim Status
The policyholder of a Star Health Insurance plan can check the status of their claim via two ways – online process and offline process.
Online Process
For checking claim status online, the policyholder can visit the website of Star Health Insurance company and select the option of ‘Claim Status’
Next, the policyholder can enter details of their health plan including intimation number, ID card number etc. Next, you can click on the ‘Get Claim Status’ button to see the details
Offline Process
If you want the details via offline process, you can get in touch at the toll-free claim helpdesk number of Star health insurance at 1800 425 2255 or you may visit the nearest branch of the insurer. You just need to give your policy intimation number and ID card number to get the details on claim status.
Reimbursement Treatment
In case of reimbursement claim, you have the liberty to get the treatment done at any hospital. Also, you can visit any hospital of your choice be it network or non-network for the treatment and apply for the claim after getting discharged.
Here are the steps to follows:
- Intimate the insurer within 24 hours of hospitalisation
- The insurer may assign you a field doctor to make the hospitalisation process simple
- While getting discharged, you have to pay all hospital bills and collect the original receipts and other bill documents like discharge summary, prescription, medical bills, etc.
- You must then submit the duly-filled form of reimbursement claim along with all the original documents to the insurer within 30 days of getting discharged to make the reimbursement claim
- Once the papers are verified well and approved by the insurer, the claim is credited in the bank account of the insured
Documents Required for Star Health Insurance Reimbursement Process
​Here is a list of documents that you need to file a reimbursement claim:
- ​Original medical reports
- Discharge summary final copy from hospital
- FIR or post-mortem (if required)
- Bills of medicines at the pharmacy and prescriptions
- All original reports
- Duly-filled claim form
- Original bills and photo ID proof
- Report by the treating doctor as well as the original consultation prescription
- Copy of surgeon’s bill and receipt
- Test reports etc.
The claim settlement ratio is calculated and published by the Insurance Regulatory and Development Authority of India (IRDAI). It is calculated as the percentage of claims paid by the insurance company against the total claims made on it.
Thus, the claim settlement ratio’s formula is (claims paid / claims made during the year) * 100.
The higher the ratio the higher the claims insurance company has paid. a higher percentage is always better as it shows the insurance company to be trustworthy.
Star Health’s claim settlement ratio is 99.06% and it is, therefore, considered to be a reputed insurance company that not only settles the maximum number of claims which are made on it but also offers a range of innovative health insurance products. So, if you want to buy health insurance plan, choose Star Health and enjoy unique products and high claim settlement ratios.
Claim Process for Cashless Treatment
The policyholder of a Star Health Insurance can avail cashless claims only at the network hospital of the insurer. With an extensive network of 9,300+ hospitals in its network, Star health insurance allows its policyholders to enjoy maximum flexibility in terms of cashless claims.
Here are the steps to follow:
- Get admitted at a hospital near you that is listed in the network of Star Health insurance
- Inform the insurance company within 24 hours in case of emergency hospitalisation and within 2 days or 48 hours before getting admission if it is a planned hospitalisation
- Do not forget to carry the Star Health ID card and one photo ID proof with you to the hospital
- Now, you have to collect the form of pre-authorization that is available at the hospital counter. Submit the form at the hospital after filling it
- Once the hospital confirms your identity, they will send the request form to the insurer
- The insurer reviews the papers and approves it
- Once that is done, the hospital proceeds with the cashless treatment
- However, if the insurer denies cashless claim, then the policyholder can get the treatment done at the hospital, pay for it and later after getting discharged can file for a reimbursement claim
How to Check Star Health Insurance Policy Claim Status
The policyholder of a Star Health Insurance plan can check the status of their claim via two ways – online process and offline process.
Online Process
- For checking claim status online, the policyholder can visit the website of Star Health Insurance company and select the option of ‘Claim Status’
- Next, the policyholder can enter details of their health plan including intimation number, ID card number etc. Next, you can click on the ‘Get Claim Status’ button to see the details
Offline Process
If you want the details via offline process, you can get in touch at the toll-free claim helpdesk number of Star health insurance at 1800 425 2255 or you may visit the nearest branch of the insurer. You just need to give your policy intimation number and ID card number to get the details on claim status.
Reimbursement Treatment
In case of reimbursement claim, you have the liberty to get the treatment done at any hospital. Also, you can visit any hospital of your choice be it network or non-network for the treatment and apply for the claim after getting discharged.
Here are the steps to follows:
- Intimate the insurer within 24 hours of hospitalisation
- The insurer may assign you a field doctor to make the hospitalisation process simple
- While getting discharged, you have to pay all hospital bills and collect the original receipts and other bill documents like discharge summary, prescription, medical bills, etc.
- You must then submit the duly-filled form of reimbursement claim along with all the original documents to the insurer within 30 days of getting discharged to make the reimbursement claim
- Once the papers are verified well and approved by the insurer, the claim is credited in the bank account of the insured
Documents Required for Star Health Insurance Reimbursement Process
Here is a list of documents that you need to file a reimbursement claim:
- Original medical reports
- Discharge summary final copy from hospital
- FIR or post-mortem (if required)
- Bills of medicines at the pharmacy and prescriptions
- All original reports
- Duly-filled claim form
- Original bills and photo ID proof
- Report by the treating doctor as well as the original consultation prescription
- Copy of surgeon’s bill and receipt
- Test reports etc.
The Claim Settlement Ratio of Star Health Insurance is calculated by dividing the total number of claims received by the company during a financial year by the total number of claims settled by the insurer during that period.
The cashless claims under Star Health Insurance plans can be done by following the steps below:
· Visit a network hospital of your choice and inform the insurer about the hospitalisation
· Show your health insurance ID card at the hospital
· Submit the required documents, which will be verified by the insurer
· Once verified, you can avail the treatment, while the settlement of the bill will be done by the insurer directly
As per IRDAI, Star Health Claim Ratio is 99.06%.
In case of reimbursement claims, the expenses of the bills are settled within 15 days from the date of discharge.
Yes, you can claim against pregnancy expenses under Star health insurance.
You can either call the toll-free number 1800 425 2255 or drop an e-mail to inform Star Health Insurance Company in case you lose your health card.
If it is an emergency hospitalization, the insured should inform the company within 24 hours of getting hospitalized. If it is planned hospitalization, the insured should inform the company/insurer about the hospitalization within 48 hours of being admitted.
A policyholder can make as many claims as they want in a policy year. However, the number of claims you made should not exceed the limit of your sum insured.
Author Bio
Paybima Team
Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
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