Cholamandalam MS Health Insurance Claim Settlement

Cholamandalam MS health insurance's claims settlement procedure is a simple process which can be completed in just a few minutes and easy online mode. The Cholamandalam MS health claim settlement is being operated in two major modalities, cashless and reimbursement.

 The cashless operation is being directly settled through a sizable number of empanelled network hospitals on the database of health Cholamandalam MS facilities, as per the policy terms and conditions, whereas in the reimbursement option, the bills incurred within the coverage of the health insurance plan need to be submitted and approved for further money settlement for the policyholders.

The Claim Process for Cashless Treatment for Cholamandalam MS Health Insurance Claim Settlement

The Cholamandalam MS health insurance claim settlement comes in with the cashless treatment benefit, which ensures that you do not need to pay your medical bills,  and some other expenses in those stressful times when you admit to the network hospitals, provided they are empanelled with Cholamandalam MS health insurance. 

Cholamandalam MS health insurance will pay all your insured expenses once you submit the claim and inform the company regarding your admission. You might have access to 10,000+ network hospitals under their partnership, where you can access cashless treatment. The high Cholamandalam MS health claim ratio of 95% is quite evident that it assures you a hassle-free treatment process. 

The whole process of the Cholamandalam MS health insurance claim settlement can be processed in two ways, planned hospitalisation or emergency hospitalisation. The only difference between the two procedures is, the time you have to inform the hospital authorities about your hospitalisation requirements. Regarding planned hospitalisation, you will have to complete and submit the form before the hospitalisation, and regarding emergency hospitalisation, you will have to contact the company at the time of hospitalisation and the form should be submitted within 24 hours.

The simple  process of Cashless Cholamandalam MS Health Insurance Claim Settlement is as follows :

1. Firstly you need to locate the best facility centre for  Cholamandalam MS network hospital in your nearest proximity where you would access cashless Cholamandalam MS health insurance claim settlement.
2. Please carry the cashless Cholamandalam MS card or the insurance number and member ID while attending a network hospital and place the same for the officials attending over there.
3. The member ID card or policy number should be presented to the hospital's insurance desk.
4. The physician's prescription for a recommendation of the hospitalisation is to be kept with you.
5. Fill out the hospital's pre-authorization form completely and accurately for identification proof.
6. The pre-authorization form after submission will be validated and approved by the Cholamandalam MS health insurance company as per the assessment done by the team regarding the claim information received.
7. The team at Cholamandalam MS health insurance then informs the policyholder and the network hospital regarding the updated status of the claim settlement as per the assigned health insurance plan.
8. Cholamandalam MS will cover the medical costs after assessing all the queries of the claim settlement team, and after receiving the required documents and medical bills from the policyholder.
9. The claim settlement is being done at the network hospital directly as per the terms and conditions applied in the health insurance plan.

The Cashless Claim Procedure After Admission

The procedure of the cashless claim is a simple process. When you have been admitted to a network hospital and place all the necessary supportive documents required for the claim settlement, the hospital authority accordingly forwards the same to the TPA in charge. Then it requires approval from the claim settlement team to start your treatment immediately.  If there are any changes in the amount of the cashless sum, the hospital authority or the TPA in charge may inform you accordingly and you have to submit the required additional documents as per the norms.

For the Cholamandalam MS health insurance claim settlement, the TPA in charge of the hospital authority will process the discharge certificate and the invoice of the claim amount to the company, and then the company will ensure the payment as per the policy and norms, excluding any expenditure prohibited by law.

List of Documents Required for Cholamandalam MS Health Cashless Claim

The documents  required for the cashless claim are as follows:

1. The doctor's prescription with details of ailments, medicines, all the laboratory test details and recommendations for hospitalisation.
2. Any case history or case papers if available.
3. The FIR or GD  documents if available.
4. Your coverage and insurance details.
5. Properly filled in and signed the original claim form.
6. Your name, address, and contact information for the hospital records.
7. Your valid ID proof along with a photograph.
8. The name and contact of the treating doctor.
9. The vehicle details for transport, like ambulance receipt.
10. The medical bills from the registered medical shop.
11. The admission details and discharge certificate with supportive documents.
12. Any other need-based additional information as required by the hospital authority.

How to Check  Cholamandalam MS Health Insurance Policy Claim Status?

Owners of Cholamandalam health insurance can check the progress of their policy claims online on the insurer's website. Policyholders can keep track of their policy date, renewal status, premium receipts, claim settlement ratio of Cholamandalam MS health insurance and other information in addition to the health claim status. You may check the status of the Cholamandalam health insurance claim both online and offline.

You can check your Cholamandalam MS health insurance claim settlement and policy online status in a hassle-free manner with the following instructions:

The Online Process for  Cholamandalam MS Health Insurance Claim Settlement

Here is how to check the status of a Cholamandalam MS health insurance claim on your own:

1. Visit the Chola MS General Insurance Company website.
2. According to the dropdown on the homepage, you must log in to the customer portal here.
3. You will be forwarded to the claim track status page.
4. On the left-hand side of the screen, ‘Track your Claim’ will be visible.
5. You can choose between two options on the right side of the page: Individual and Corporate.
6. Choose the individual and corporate options for your individual and group health insurance, respectively.
7. After choosing the individual option, you must input the reference number in the space provided below this tab, or you may enter the claim reference number, or you may enter both fields.
8. Following that, you must provide your policy number and date of birth.
9. To obtain the claim number for your Cholamandalam MS health insurance settlement ratio, simply click the "Continue" button.

The Offline Process for  Cholamandalam MS Health Insurance Claim Settlement

If for some unforeseeable reason you are not able to check your Cholamandalam MS health insurance claim settlement online, you can avail of other options as well. You can seek assistance with the claim status by going to the branch office of the Chola MS General Insurance Company. You will be required to provide the claim form and policy number to the staff members at the insurer's office. Give all the information required and be aware of the progress of your Cholamandalam MS health claim ratio. You can contact the Chola MS at 1800-208-9100,  Whatsapp (7305234433) or send an email on their registered email (customercare@cholams.murugappa.com) to inquire about the progress of your claim. Through the CHOLA MS SMS service, you may also maintain tabs on the status of your Cholamandalam MS health claim ratio. Texting SMS "CHOLA" to 56677 will allow you to check the progress of a claim under your Chola MS mediclaim coverage. The policy information, including your claim number and any other information pertaining to the coverage, may also be checked.

The Claim Process for Reimbursement Treatment for  Cholamandalam MS Health Insurance Claim Settlement

You can submit for reimbursement regarding Cholamandalam MS health insurance claim settlement regardless if you receive treatment from a network hospital or a non-network hospital. Here are the steps you need to follow in order to do so:

• In the event that you are admitted to a hospital outside of the network, you must notify the insurer within 48 hours of the admission.
• When you are being discharged from the hospital, get the care you need and pay all of your medical costs there.
• Within 30 days after receiving hospital release, self-attesting, and scanning and uploading any pertinent claim documentation.
• Within 7 working days, the insurer will evaluate all the paperwork and provide permission.
• Cholamandalam MS General Insurance will pay the claim amount using NEFT.

List of Documents Required for Cholamandalam MS Health Reimbursement Claim

Here are the documents needed for the Cholamandalam MS health claim settlement ratio:

1. Properly completed and signed claim form
2. A prescription from a physician recommending admittance
3. Hospital-issued discharge card
4. Original final hospital bill and payment receipt
5. Reports of medical investigations
6. Medications and the prescriptions that go with them
7. Sticker or invoice for implants if they were utilised during surgery
8. Additional invoices or records pertaining to the therapy Medico Legal Certificate (MLC) or FIR in the event of a traffic accident (RTA)
9. Cancelled check from an insured bank account to pay the claim using NEFT

Please remember that Cholamandalam MS may need additional documents.

Incurred Claim Ratio (ICR) of Cholamandalam MS Health Insurance

The Cholamandalam MS Incurred Claim Ratio, or ICR is the ratio of the entire amount of claims paid out by the business to the total amount of premiums accrued within a specific time period. ICR provides the display regarding the speed at which the claims were resolved. For the fiscal years 2020–21, Cholamandalam MS health insurance's ICR is 77.35%. 

 Cholamandalam MS Health Insurance Claim Settlement Ratio (CSR)

The claim settlement ratio measures how many claims were settled by Cholamandalam MS health claim settlement ratio and how many claims were submitted overall. A percentage is used to represent this. For the fiscal year 2021, the claim settlement ratio for Cholamandalam MS health insurance is 91.47% in less than 3 months and 4.47% in 3 months to 6 months. This successfully ensures that potential customers have the best reasonable defence against a medical claim. Remember that the ratio of claim settlements varies.