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Star Health Insurance Claim Settlement Ratio

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Star Health Insurance Claim Settlement Ratio

Buying health insurance requires checking the performance of the health insurance company to avoid problems in medical emergencies. One of these factors is the health insurance company's claim settlement ratio (CSR), which you should check before buying health insurance. What is the use of a health insurance policy if your health insurance company cannot process your claims on time? The article below will explain the Star health insurance claim settlement ratio and its importance.

What is a Claim Settlement Ratio?

Claim Settlement Ratio (CSR) is the percentage of claims settled by a health insurance company in a year. In other words, the percentage of claims an insurer pays in a financial year. The ratio measures the difference between the number of claims filed and the number of claims settled.

Formula to calculate the claim settlement ratio of any health insurance company: Number of claims settled/Number of claims received x 100

If you have decided to buy a health plan from Star Health, looking at its settlement ratio can give you an idea of ​​how well it handles claims. It will also give an idea about the company’s ability of the timely claim settlement.

Star Health Insurance Claim Settlement Ratio

Star health insurance has a claim settlement ratio of 99.06. Look at the table below to understand Star Health claim settlement ratio.

Status of Star Health Claim Settlement ratio- 2021-22
Age Analysis of Number of Claims Paid (%) < 3 months 3 months to 6 months 6 months to <1 year 1 year to <3 year 3 years to <5 years 5 years
Claims Settled 99.06 0.70 0.20 0.05 0.01 -

Star Health Insurance Claim Process

Star health insurance offers two simple ways to file claims. Below we have explained both the claim processes of star health insurance in detail:

Cashless Claim Process

  • Intimate the star health insurance company about the treatment.
  • Get to the hospital's insurance desk and show your star health insurance health card.
  • The pre-authorization form is available for download on the star health insurance website.
  • Fill the asked information and submit the form to the star health insurance for the verification.
  • The insured can use a cashless treatment facility after the claim has been successfully verified and accepted. The company will take care of all the bills.

Reimbursement Claim Process

  • If the treatment is received in a non-network hospital or if your cashless claim has been denied, you can submit a reimbursement claim.
  • Inform the star health insurance within 24hrs of hospitalization.
  • Avail the treatment, pay the bills, and submit a reimbursement claim.
  • Send all necessary documents including hospital and pharmacy bills, the claim form, and all original records of the patient's medical care within 15 days of recharge.
  • The star health insurance company will verify the documents and process the claim. You will receive a call or email confirming the same.
  • Now, you will get the reimbursement amount in your registered bank account.