Digit Health Insurance Claim Settlement

There are a few important pointers that you should check when purchasing the correct health insurance policy for you and your family. Digit health insurance offers one of the best and most easy-to-understand claim settlement procedures that you can make use of when the time comes. The Digit health insurance settlement ratio has been on the higher side, which is a great thing for you as a policyholder. In the health insurance sector, companies generally offer two types of insurance claims, and these are also available with the Digit health insurance plan. Here, you can find more detailed information on the Digit health insurance claim settlement procedure.

The Claim Process for Cashless Treatment for Digit Health Insurance Claim Settlement

Through the wide selection of 6400+ partnered hospitals under Digit health insurance, the company provides the facility of quality cashless treatment and medical care across India. Apart from that, the reports indicate a great Digit health claim ratio, which is something you would want your insurance provider to have. By opting for the cashless treatment facility under the Digit health insurance plan, you will not have to take care of the hospitalisation and treatment bills. All you would need to do is inform your insurer about the correct procedure, and the company will handle the bills so that you can focus on getting better. Also, remember that this facility is only offered within the range of partnered hospitals under the insurance company and is not available if you get treatment from a non-network hospital.

Guide to the Cashless Claim Treatment

If you want to get cashless treatment under your Digit health insurance plan then you will need to get admitted to an affiliated hospital under the insurer and get your treatment done there. Your plan’s provider will take care of the bills after you follow through with the procedure as stated below.

This is how you can submit a cashless Digit health insurance claim settlement:

Before starting with the procedure of submitting a cashless Digit health insurance claim, we need to talk about the two different types of cashless claims that are available. The first choice is a planned cashless claim process and the second choice is an emergency cashless claim process.

Planned Cashless Digit Health Insurance Claim Settlement Process

If you are going for a planned hospitalisation procedure, you can get the benefits of a cashless claim. Under these circumstances, you will be required to inform and get checked with the network hospital a few days in advance and follow up with the necessary paperwork for the process, including the pre-authorisation form. The hospital will forward the documents and the form to your plan’s insurer. Once the verification process is made by the insurance company, and the permission for the cashless treatment goes through, you will be able to take the benefits of the cashless claim.

Emergency Cashless Digit Health Insurance Claim Settlement Process

In case of emergency hospitalisation caused by critical medical failure or an accident, letting the hospital or your insurer know beforehand is not an available option. But, even without prior notice, you can avail of the cashless claim benefit by getting admitted to a network hospital under the policy and using the health card that has been given to you by your insurer. A few pieces of paperwork must be submitted, including the pre-authorization letter, and once the insurer approves the treatment procedure, you will be able to receive cashless treatment. 

The Cashless Claim Procedure After Admission

1. After getting admitted to a network hospital under the Digit health insurance plan, you will have to contact the TPA located at the hospital, and they will send the submitted pre-authorisation application to the insurance company.
2. As soon as the initial permission for treatment comes in from the insurer, the operation and treatment will begin.
3. After that, the essential documents required for the procedure are to be provided to the TPA at the hospital. They will check it with the insurer in case a more cashless sum is required for the treatment.
4. The final hospital invoice will be sent to you on the day of discharge, alongside the discharge statement.
5. The final authorisation over the total bill amount will then be composed by the TPA or the insurance company after reviewing your claim submission.
6. A few hospital-related expenditures, which are excluded under the policy, will be charged directly to you by the hospital (if any).

List of Documents Required for Digit Health Cashless Claim

The general documentation that you will need for the Digit health insurance cashless claim procedure is: 

1. Prescription provided by the doctor regarding the need for hospitalisation
2. The health card provided to you by the insurer
3. The proof of identity, age and address
4. Details of medical reports and tests that were made prior to hospitalisation

These are some of the documents that you will need, and the rest will be provided by the hospital. 

How to Check Digit Health Insurance Policy Claim Status?

The Digit health insurance claim ratio is great, and if you have already registered a claim under the policy, you can easily check the claim progress through the official website of the insurer. You can also opt to check your claim status through the offline process if you want.

Here are the steps to check your Digit health insurance claim settlement status in both modes:

The Online Process for Digit Health Insurance Claim Settlement Status

1. Go to the official website of Digit health insurance and navigate to the “Claim“ section.
2. After that, scroll down to find the “Claim Status” option and click on it.
3. Then, you will be directed to the official WhatsApp chat help, where you will have to provide the policy details under claim inquiry in order to get the status details of your Digit health insurance claim settlement.

However, to get the Digit health insurance claim ratio, you can check with the official reports released by the company.

The Offline Process for Digit Health Insurance Claim Settlement Status

If you want to check the status of your Digit health insurance claim settlement, you can visit the health insurance company branch situated near your location. Or you can always give a ring to their toll-free number, which is 1800-258-5956 or contact them at their email address, which is healthclaims@godigit.com.  

The Claim Process for Reimbursement Treatment for Digit Health Insurance Claim Settlement

The other way you can apply for insurance claims with the Digit health insurance plan is through the reimbursement option. If you go with the reimbursement option, you will need to pay for all the hospitalisation and medical bills from your own pocket. After that, you will need to provide the medical cost, treatment-related bills and the essential documents to file for a reimbursement claim, and the insurance company will verify all the provided documents and claim-related paperwork. After the verification process is done and the claim is approved, the reimbursement money will be transferred to your registered bank account. 

The reimbursement claim is a great alternative to the cashless claim option in the event you can’t get a network hospital for treatment. 

Here is how to submit a claim for reimbursement:

1. After paying for the hospitalisation and the related treatment bills from your own pocket, you can then file for a reimbursement claim.
2. The claim has to be filed within the stipulated time period as stated by the company, which is within two days of the admission. You can contact the insurer by dialling 1800-258-5956 or by emailing them at healthclaims@godigit.com.
3. The insurer will provide you with a link, and you can upload all your treatment bills and attached documents for the reimbursement claim within 30 days from the date of release from the hospital. You will have to sign these documents yourself and write ‘For Digit’ on them before uploading.
4. It can take a few days to process your claim, and once it goes through successfully, the approved claim amount will be transferred to your enlisted bank account within 30 days from providing the last required claim document.

List of Documents Required for Digit Health Reimbursement Claim

With Digit health insurance, you will need to provide this information for a reimbursement claim;

1. The name of the patient
2. Insurance policy number
3. ID proof of the insured
4. Details of the injury or treatment
5. The admission date
6. The hospital’s name and its location
7. The name of the assigned physician
8. Other additional general information

These are the documents that are required to be submitted to Digit for claim settlement:

1. A duly filled and signed form of claim
2. The hospital dismissal details
3. Associated medical records and tests
4. The original copy of the primary hospital bill, pharmacy bill along with prescriptions, etc.
5. Investigation and consultation papers
6. If required, digital images of the investigation process will be needed
7. KYC bank details with a cancelled cheque
8. Additional documentation might be required

Digit Health Insurance Incurred Claim Ratio (ICR)

Health insurance companies generally earn their revenue by collecting premiums on their policies. This is also how they settle insurance claims that are made within a term year. So, the Incurred Claim Ratio or the ICR of a company is the ratio of the total number of claims settled to the total number of collected premiums by the insurer within a financial year. This data is very crucial and is released by the Insurance Regulatory and Development Authority of India (IRDAI) to give consumers across the nation a clearer idea. According to the latest reports by the IRDAI, the ICR of Digit health insurance for the fiscal year 2020-21 was 63.80%.       

Digit Health Insurance Claim Settlement Ratio (CSR)

The Digit health claim settlement ratio gives you an idea about the chances of your insurance claims being settled. The claim settlement ratio or the CSR is the ratio of total resolved claims to the total filed claims within a financial year. This data is not released by IRDAI and depends on the company to provide it. The claim settlement ratio of Digit health insurance for the fiscal year of 2019-20 has been on the higher side. The company suggests having 99.65% of claims settled within less than three months, and about 0.24% of claims required between three to six months to get settled.